03. tbl. 100. árg. 2014

Family-based behavioral treatment for obese children - Results and two year follow up

Fjölskyldumiðuð atferlismeðferð fyrir of feit börn

Introduction: Childhood obesity has become a worldwide epidemic and Icelandic children have not been exempt from increasing rates of obesity. Epstein´s family-based behavioral treatment for childhood obesity has demonstrated favorable outcomes in research settings, but research in clinical settings has been called for. The objective of this study was to replicate and confirm the effects observed in the US research setting.

Material and methods: Participants were 84 obese children (age-range: 8-13 years) and a participating parent. Sixty-one families completed a 12 week treatment lasting 18 weeks, and were followed for one and two years post-treatment. Measurements at baseline and end of treatment included height and weight, daily activity, daily fruit and vegetable consumption, blood pressure, blood profiles and measures of psychological well-being. Measurements also included parental height, weight and depression scores.

Results: Among treatment completers BMI-SDS (body-mass index standard deviation score) decreased significantly from pre- to post- treatment (F(2.60)=110.31, p<0.001) which was maintained at one-year (F(2.60)=1.33, p=0.253) and two-years (F(2.60)= 3,19, p=0.079) post treatment. There was a significant reduction in blood pressure (upper: t(59)=-2.01, p<0.05, lower: t(59)=-4.00, p<0.001). Among a subsample (n=23) of participants, significant reductions were observed in fasting insulin levels, (t(22)=6.1, p<0.05), triglycerides (t(22)=0.31, p<0.05) and total cholesterol (t(22)=0.35, p<0.05). Significant improvements were observed for measures of psychological well-being (depressive symptoms: (F(1.59)=6.67, p<0.05); anxiety: (F(1,57)= 4.54, p<0.05) and children´s self-concept (F(1.59)=19.2, p<0.001). A significant reduction was observed in parental BMI scores from pre- to post- treatment (F(1.59)= 71.54, p<0.001) but a significant increase was evident at one year post-treatment (F(1.59)=41.87, p<0.001). Improvements were observed for measures of parental depression from pre- to post- treatment (F(1.60)= 12.93, p<0.01).

Conclusion: Epstein´s family-based behavioural treatment showed promising effects on weight status, and emotional as well as physical markers, both in the short and long term in a clinical sample of obese Icelandic children.

Correspondence: Thrudur Gunnarsdottir, thrudur.gunnarsdottir@ucdenver.edu

Keywords: childhood, obesity, family-based, treatment

1Department of Pediatrics, University of Colorado, 2BUP dogn – enhet for ungdom, Elverum, Sykehuset Innlandet, Norge, 3University of Iceland, School of Health Sciences, 4University of Iceland, School of Education, 5Landspítali University Hospital, Reykjavík, 6Department of pediatrics, Landspítali University Hospital, Reykjavík, Iceland.

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