Effect of a family-based cognitive behavioural intervention on body mass index, self-esteem and symptoms of depression in children with obesity (aged 7–13): A randomised waiting list controlled trial

• Published in: Obesity research & clinical practice 2013-03, Vol.7 (2), p.e116-e128
• Main Authors: Danielsen, Yngvild S, Nordhus, Inger H, Júlíusson, Petur B, Mæhle, Magne, Pallesen, Ståle
• Format: Article
• Language: English
• Subjects: Adolescent; Behavior Therapy; Body Composition; Body Mass Index; Child; Cognition; Depression - etiology; Depression - therapy; Depressive Disorder - complications; Depressive Disorder - therapy; Endocrinology & Metabolism; Female; Humans; Internal Medicine; Lipids - blood; Male; Pediatric Obesity - blood; Pediatric Obesity - complications; Pediatric Obesity - psychology; Pediatric Obesity - therapy; Self Concept; Sex Factors; Treatment Outcome; Waiting Lists; Weight Reduction Programs
• ISSN: 1871-403X
• DOI: 10.1016/j.orcp.2012.06.003

Summary Objective We examined the effect of a 12-week family-based cognitive behavioural weight management programme developed for use in primary care settings. Methods The sample consisted of 49 children with obesity (aged 7–13 years; mean ± SD: 10.68 ± 1.24). Families were randomly assigned to immediate start-up of treatment or to a 12-week waiting list condition. Outcome measures were body mass index standard deviation score (BMI SDS), self-esteem, symptoms of depression and blood parameters indicative of cardio-metabolic risk. Assessments were conducted at baseline, post-treatment, post-waiting list and 12 months after treatment termination. Results The mean reduction for the treatment group was −0.16 BMI SDS units compared with an increase of 0.04 units for the waiting list group ( p = .001). For the entire sample, there was a significant post-treatment improvement on BMI SDS ( p = .001), all self-esteem measures ( p = .001–.041) and symptoms of depression ( p = .004). The mean BMI SDS reduction was −0.18 units post-treatment, and it was maintained at 12-month follow-up. Significant reductions were found in blood lipid levels of total cholesterol ( p = .03), LDL-cholesterol ( p = .005) and HDL-cholesterol ( p = .01) at 12-month follow-up. The favourable effect on most of the psychological measures waned from post-treatment to follow-up, but not approaching baseline levels. Boys demonstrated significantly greater reductions in BMI SDS than girls ( p = .001), while baseline psychiatric co-morbidity did not influence BMI SDS outcome. Conclusions The treatment shows significant and favourable effects on BMI SDS, self-esteem and symptoms of depression compared with a waiting list condition.