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  • 1. Title Author Van Vlierberghe, L., Braet, C., Goossens, L., Rosseel, Y., &Psychological disorder, symptom severity and weight loss in inpatient Mels, S.adolescent obesity treatment Kitzmann, K. M., Dalton, W., Stanley, C. M., Beech, B. M.,Lifestyle interventions for youth who are overweight: A Reeves, T. P., Buscemi, J., &meta-analytic review … Midgett, E. L. Goldfield, G. S., Raynor, H. A.,Handbook of Obesity Treatment Epstein, L. H.
  • 2. Epstein, L. H., Paluch, R. A.,The Effect of Reinforcement or Stimulus Control to Reduce Sedentary Kilanowski, C. K., & Raynor H. A.Behavior in the Treatment of Pediatric Obesity.Family-based interventions for pediatric obesity: Methodological andconceptual challenges for family psychology Kitzmann, K. M., & Beech, B. M. Pratt, K. J., Lamson, A. L., Collier, D. N., Camp Golden Treasures: A multidisciplinary weight-loss and a Crawford, Y. S., Harris, N., Gross, K., &healthy lifestyle camp for adolescent girls. ... Saporito, M.Psychological interventions in the treatment of childhood obesity:What we know and need to find out. Bogle, V., & Skykes C.Empriically Supported Treatments in Pediatric Psychology: PediatricObesity. Jelalian, E., & Saelens, B. E.Etiology, Treatment, and Prevention of Obesity in Childhood andAdolescence: A decade in Review. Srunijt-Metz, D.
  • 3. Growth Rate Reduction during energy restriction in obese Amador, M., Ramonths, L.T., Morono,adolescents. M., & Hermelo, M.P.Treating overweight children through parental training and Aragona, J., Cassady, J., & Drabman,contingency contracting. R.S.The effect of physical activity on the body measurements and work Blomquist, B., Boreson, M., Larsson, Y.,capacity of overweight boys. Persson, B., & Sterky, G.The effectiveness of cognitive self-management as an adjunct to abehavioral intervention for childhood obesity. Duffy, G. Spence, S.H. Epstein, L. H., McKenzie, S.J., Valoski,Effects of mastery criteria and contingent reinforcement for family- A., Klein, K.R., & Wing, R.R.based child weight control.
  • 4. Epstein, L.H., Valsoki, A., Vara, L.,Effects of decreasing sedentary behavior and increasing activity on McCurley, J., Wisniewski, L., Kalarchian,weight change in obese children. M.A.,Klein, K.R., & Shrager, L.R.Child and parent weight loss in family-based behavior modification Epstein, L.H., Wing, R.R., Koeske, R.,programs. Andrasik, F., & Ossip, D.J.A comparison of life-style change and programmed aerobic exercise Epstein, L.H., Wing, R.R., Koeske, Ossip,on weight and fitness changes in obese children. D.J., & Beck, S. Epstein, L.H., Wing, R.R., Koeske, R., &Effects of diet plus exercise on weight change in parents and children. Vasloski, A.
  • 5. A comparison of life-style exercise, aerobic exercise, and calistehenics Epstein, L.H., Wing, R.R., Koeske, R., &on weight loss in obese children. Valoski, A. Epstein, L.H., Wing, R.R., Koeske, R., &Effects of parent weight on weight loss in obese children. Valoski, A.The effect of diet and controlled exercise on weight loss in obese Epstein, L.H., Wing, R.R., Penner, B.C.,children. & Kress, M.J.Comparison of family-based behavior modification and nutrition Epstein, L.H., Wing, R.R., Steranchak, L.,education for childhood obesity. Dickson, B., & Michelson, J.
  • 6. Stability of food preferences during weight control: A study with 8- to Epstein, L.H., Wing, R.R., Valoski, A., &12 - year olf children and their parents Gooding, W.Effects of family-based behavioral treatment on obese 5- to 8- year- Epstein, L.H., Wing, R.R., Valoski, A., &old children. Penner, B.C.The modification of activity patterns and energy expenditure in obese Epstein, L.H., Woodall, K., Goreczny,young girls. A.J., Wing, R.R., & Robertson, R.J.An evaluation of enhanced self-regulation training in the treatment of Israel, A.C., Guile, C.A., Baker, J.E., &childhood obesity. Silverman, W.K.Treatment of ovese children with and without their mothers: changes Brownell, K.D., Kelman, J.H., &in weight and blood pressure Stunkard, A.J.
  • 7. Figueroa-Colon, R. von Almen, T.K., Franklin, F.A., Schuftan, C., & Suskind,Comparison of two hypocaloric diets in ovese children. R.M.Obesity management via diet and exercise intervention Hills, A.P., & Parker, A.W.
  • 8. Year Journal Volume Page No. DOI International Journal of Pediactric Obesity 2009 4 36-44 10.1080/17477160802220533 2010 Health Psychology 29 91-101 10.1037/a0017437 2002 Book 532-555
  • 9. 2004 Health Psychology 23 371-380 10.1037/0278-6133.23.4.371 Couple And Family Psychology: Research And Practice2011 1 42-62 10.1037/2160-4096.1.S.45 Families, Systems,2009 and Health 27 116-124 10.1037/a0014912 Journal of Health2011 Psychology 16 997-1015 10.1177/1359105310397626 Journal of Pediatric1999 Psychology 24 223-248 Journal of Research on2011 Adolescence 21 129-152 10.1111/j.153-7795.2010.00719.x
  • 10. Experimental and Clinical1990 Endocrinology 96 73-82 Journal of Applied Behavioral1975 Analysis 8 269-278 Acta Paediatrica1965 Scandinaciva 54 566-572 Journal of Child Psychology 1043-1993 and Psyhiatry 34 10501994 Addictive Bheaviors 19 135-145
  • 11. 1995 Health Psychology 14 109-115 Journal of Consulting and1981 Clinical Psychology 49 674-6851982 Behavior Therapy 13 651-665 Journal of Consulting and1984 Clinical Psychology 52 429-437
  • 12. 1985 Behavior Therapy 16 345-356 Journal of Consulting and1986 Clinical Psychology 54 400-4011985 Journal of Pediatrics 107 358-361 Journal of Pediatric1980 Psychology 5 25-36
  • 13. 1987 Behavioral Modification 11 87-1011985 Behavioral Therapy 16 205-2121984 Behavioral Therapy 15 101-108 Journal of Pediatric1994 Psychology 19 737-7491983 Pediatrics 71 515-525
  • 14. American Journal of Diseases1993 in Children. 147 160-166 Child Care, Health and1988 Devleopment 14 409-416
  • 15. Population Method Analysis * t -tests conducted for YSR and EDE-Q subscales *R - software for statistical computing of graphics was used to account for missing data*Adolescence (14-19 yrs) *3 Regression analysis*Possesing psychological run (1 month, 4symptoms or disorders Empirical Study; months, end of*66 Participants Quantiative Study treatment) Empirical Study; *Effect Size Analysis*Overweight (~20%) Meta Analysis; Software*6- 18 years old Quantiative Study *SPSS *Between-groups comparisons of previously collected*Obese Children (5-17 yrs) data Empirical Study
  • 16. *Graphs and charts of data comparing pre and post treatment outcomes for both Empirical Study; groups*Obese 8-12 year old children Quantitative Study *Graphs of changes of*child in 85th BMI percentile BMI overtime*Overweight children from 1-18years of age Data Based Meta Analysis Comparisons*56 overweight girls (10-18years) Qualitative Study *Data comparison *evaluated studies psychological interventions combined with dietary*obese adolescents (age 5-16 and physical activityyears) components*pediatric obesity (12 years andyounger) *compare studies *between-study*obese children (2-18 years) comparison
  • 17. *Overweight children (0-13years) Experimental Design *weekly sessions *12 weekly sessions *Parent only sessions *info about exercise, calisthenics, nutrition,*15 girls and stimulus control*Ages 5-10 *explained response*overweiht cost and*no medical, psychological, or *Experimental Design reinforcement,psychiatric treatment and not in *Randomized group reponse cost, andanother weight control program *2 week baseline waitlist control*43 participants *physical activity 2*ages 8-9 years times a week for 4*overweight child *Experimental Design months *Randomized group *no treatment control* 21 participants*Average percent overweogjt *Experimental Design48.36% *Randomized group *8 weekly, 90-minute*Age 7-13 years group sessions *26 weekly meetings* 44 participants followed by 6 monthly*74% female, 26% male *Experimental Design meetings*Age 8-12 years *Randomized group
  • 18. *weekly session for 4 months then 2 month* 61 subjects *Experimental Design meetings*Age 8-12 years *Randomized group *14 sessions (8 weekly* 44 participants sessions followed by 6*74% female, 26% male *Experimental Design monthly sessions)*Age 8-12 years *Randomized group* 51 participants*children 20-80% overweight*Age 8-12 years*no existing *8 weekly sessionspsychological/psychiatric then 5 maintenancecondition *Experimental Design sessions over 4 months *Randomized group* 53 participants*children 20-80% overweight*Age 8-12 years*no existingpsychological/psychiatric * 8 weekly sessionscondition then 7 sessions over 20*no contra-indications for *Experimental Design weeksexercise *Randomized group
  • 19. * 44 participants * 8 weekly sesssions,*children > 20 overweight then 10 monthly*Age 8-12 years *Experimental Design sessions *Randomized group* 41 participants*children 20-80% overweight*Age 8-12 years*children not receiving *Experimental Design *8 weekly sessions,psychological/psychiatric *Randomized group then 10 monthlytreatment *crossed with parent meetings overweight status *Experimental Design* 23 participants *Randomized group*children 20-80% overweight after stratification on *8 weekly sessions*Age 8-12 years age, percent overweight, then 10 monthly*no contra-indications for and physical work maintenance sessionsexercise capacity * 13 participants*children > 20% overweight *Experimental Design*Age 6-12 years *Randomized group *7 weekly groups, then*child not receiving medical, after stratification by 3 monthly grouppsychological/psychiatric percentage overweight sessionstreatment and age
  • 20. * 41 participants*children 20% -80 % overweight *Experimental Design*Age 8-12 years *Randomized groups *8 weekly sessions,*child not receiving medical, crossed with parent then 10 monthlypsychological/psychiatric overweight status sessionstreatment (yes/no)* 19 participants*children 20% -80 % overweight *5 week camp, then 9*Age 5-8 years monthly maintenance*obese girls reffered by school *Experimental Design sessionsnurse or physician *Randomized group* 19 participants*children 20% -80 % overweight *5 weeks of 2*Age 5-8 years *Experimental Design days/weel of camp *Randomized group* 20 participants*children > 20% overweight *8 90-minute group*Age 8 years, 11 months - 13 *Experimental Design sessions, then 9years, 0 months *Randomized group biweekly sessions * 45 to 60 minute group sessions for 1* 38 participants year (16 weekly*average percent overweight = sessions, then 155.7% *Experimental Design session every 2 months*Age 12-16 years *Randomized group
  • 21. *ten outpatient* 19 participants sessions, followed by*average percent overweight = monthly sessions for 180.4 % *Experimental Design year*Age 7.5 - 16.9 years *Randomized group* 20 participants*child above 95th percentile forpercent overweight*average BMI > 25 *Experimental Design *food recording*Age: prepubertal *Randomized group *dietitian consult
  • 22. Measures Results *Severly overweight children are sucessful in loosing weight *After 4 months, boys had lost more weight than girls *psychopathology not found to significantly predict weight loss *those with eating disorders decreased binge eating*Eating Disorder Examination episodes*Structured Clinical Interview for DSM *~50% of adolescents entering treatment with at least-IV one psychological disorder kept atleast one psychiatric*Youth Self-Report diagnosis at the end of the program*BMI *Girls and severley obese adolescents require long-*Percent Overweight term care*Between-groups differences in *Interventions for overweight adolescents are effectiveweight-related outcomes under a wide range of conditions*Between-groups differences in *Improved eating habitshealth related behaviors at end of *Parents showed better weight managementtreatment themselves*BMI *key component - parent involvement in program*Percent Overweight *weight management bettered *Most successful programs include multidisciplinary design with diet, exercise, and application of behavior modification principles *exercise interventions alone do not have impact on weight change *exercise combined with diet enhances weight loss and improves long-term maintenance *less structured, more flexible lifestyle exercise may be more effective than higher intensity aerobic exercise *Reduce sedentary activity with use of structured eating plan *Including parents in family-based behavioral intervention strengthens short and long-term weight*Percent Overweight loss*Different treatment outcomes *Percent overweight decreases as duration of*BMI treatment increases
  • 23. *Daily food intake recorded*Habits book - recorded target *Decrease in percent overweightsedentary behavior times *Decrease in sedentary behavior/ intake of high density*BMI calculated and compared to CDC foodsgrowth charts *Increase in servings of fruits and vegetables* Weight and Height *Increase in percent of time above 3 METs*METs calculated daily *Increase in moderate to vigorous physical activity *Most programs include parents in behavioral or cognitive-behavioral approaches to behavior management in order to change childs eating habits*Content of intervention *Some research states that the more a parent is*Weight/Height envolved doesnt always mean the outcome will be*BMI better*Nutrion Measurment in logs *Family-based research can be more effective if aspects*Exervise Logs such as variability in parent and family function is taken*Therapy sessions into account *~6% weightloss of initial body weight for 6 weeks of*Percent Overweight attendance*Exercise *changes in obesity-related comorbidities*BMI (hypertension, insulin resistance, sleep apnea)*Eating Habits *firm conclusions about the effectiveness of*Change of weight and BMI psychological interventions for childhood obesity can*Percentage overweight not be made*dietary intake *interventions aimed atreducing sedentary*physical activity activities/increasing physical activity level effective*fitness *multi-component family-based behavioral*screen time (tv/computer, etc.) interventions are effective *well-established treatments for intervening with*compared weight loss interventions pediatric obesity in children between the ages of 8 toof several studies. 12 years*current definitions of childhoos andadolescent overweight and obesity*demography od obesity in U.S. *several studies were found the reduced BMI with*psyhcosocial correlations of pharmaceutical, physical activity, reduce sedentary,childhood and adolecent obesity and lifestyle interventions.
  • 24. *Males lost 3.2 kg after 4 weeks of treatment*weekly sessions *Females lost 2.9 kg after 4 weeks of treatment*calroie intake log *males lost 7.6 kg after 6 months*BMI measurement *females lost 8.1 kg *response cost and reinforcement group lost 11.3 lbs*Change of weight and BMI *response cost group lost 9.5 lbs*Percentage overweight *waitlist control gained 0.9 lbs*dietary intake *patients still lost weight eight weeks from post- treatment*Physical activity level*weight loss *Gained 0.8 kg*BMI *no follow up *stimulus crontrol*monitoring food & activity*goal setting and postivie *Group 1 demonstrated a 0.9% decrease in percentreinforcement over weight*relaxation training *Group 2 demonstrated a 7.8% decrease in percent*cognitive restructuring over weight*problem solving *Significant decrease in percentage of overweight*selving-reinforcement individuals in both groups *6 months from pre-treatment group 1 demonstrated 30.1% decrease in percent overweight*traffic light diet *6 months from pre-treatment group 2 demonstrated*lifestlye exercise 20% decrease in percent overweight*parents trained in behavior *Twelve months from pre-treatment Group 1management demonstrated a 26.5% decrease in percent overweight* parents and children seen in * Twelve months from pre-treatment Group 2separate groups demonstrated a 16.7% decrease in percent overweight
  • 25. *4 months from pre-months for group 1 there was approxiately a 21% decrease in overweight *4 months from pre-months for group 2 there was approxiately a 13% decrease in overweight*traffic light diet *4 months from pre-months for group 3 there was*behavioral contracting approxiately a % decrease in overweight*reinforce decreased sedentary * 12 months from pre-months for group 1 there wasactivity approxiately a 19% decrease in overweight* reinforced increased physcial * 12 months from pre-months for group 2 there wasactivity combined with behavioral approxiately a 8% decrease in overweightcontrast and decreased sedentary * 12 months from pre-months for group 3 there wasactivity approxiately a 11% decrease in overweight*traffic light diet*aerobic exercise plan*behavioral modification *significant decrease inpercentage of obesity for all*parent and child targeted weight loss groups (1,2,3)*psychiatric treatment *41 % of children were less than 20% overweight*parent participation *traffic light diet*behavior contracting*behavioral modification *at the end of maintenance group 1 was -19%*parent and child seen in different overweightgroups *at the end of maintenance group 2 was -10%* diet and lifestyle exercise (group 1) overweight*diet and programmed exercise *at the end of maintenance group 3 was 13-%(group 2) overweight*lifestyle exercise (group 3) *at the end of maintenance group 4 was -14%*programmed exercise (group 4) overweight*traffic light diet*token economy *group 1 demonstrated approximately -15%*parent and child seen in different overweightgroups *group 2 demonstrated approximately -16%* diet and lifestyle exercise (group 2) overweight*diet (group 1) *group 3 demonstrated approximately + 2%*waitlist control (group 3) overweight
  • 26. *2 months from pre-treatment group 1 was -11% overweight*self monitoring *2 months from pre-treatment group 2 was -13%*traffic light diet overweight*modeling *2 months from pre-treatment group 3 was -11%* parent behavioral management overweight*behavioral contracting * 6 months from pre-treatment group 1 was -17%*diet and programmed aerobic overweightexercise (group 1) *6 months from pre-treatment group 2 was -20%*diet and lifestyle exercise (group 2) overweight*diet and calisthenics exercise (group *6 months from pre-treatment group 3 was -16%3) overweight*traffic light diet*lifestyle exercise program*parent and child seen in differentgroups* parent control training, parentoverweight (group 1)*child self-control training, parentoverweight (group 2)*parent control training, parent not * no differential effect of parent vs. child controloverweight (group 3) *groups 1 & 2 demonstrated -7.7% overweight*child self-control training, parent not *groups 3 & 4 demonstrated -16.3% overweightoverweight (group 4) * 3+4 > 1+2 *2 months from pre-treatment group 1 was -17% overweight*traffic light diet * 2 months from pre-treatment group 2 was -12%*behavioral management overweight*parent and child seen in different *6 months from pre-treatment group 1 was -28%groups overweight* diet and aerobic exercise (group 1) * 6 months from pre-treatment group 1 was -19%* diet alone (group 2) overweight*traffic light deit*exercise instruction and calisthenicsor walking in sessions*self monitoring, stimulus control,behavioral contracting, therapstphone contact (group 1) * percent overweight group 1 -9.7%*nutrition and exercise education only *percent overweight group 2 -4.7%
  • 27. *traffic light deit* parents and children seen inseparate groups*behavioral modifications* parent control training, with parentoverweight (group 1) *child self-control training, with parentoverweight (group 2)*parent control training, with parentnot overweight (group 3) * no differential effecr of parent vs. child control* child self-control training, with * group 1 & group 2 approximately - 8% overweightparent not overweight (group 4) *group 2 & group 3 approximately - 18% overweight * 3 + 4 > 1+ 2*traffic light diet*parents seen in separate groups * 4 months from pre-treatment group 1 showed -20%* behavioral management and diet overweightand exercise program (group 1) * 4 months from pre-treatment group 2 showed -13%*diet and exercise program (group 2) overweight*traffic light diet*nutritional education* experimental:baseline, treatment,reversal, treatment, reversal (group 1)*control: baseline; treatment =random reinforcement of physicalactivity; reversal = reinforcement of * Pre-post change: -4.9 lbs across groupssharing (group 2) *1=2* parent and child seen in separategroups* monitoring, cue control, rewardingweight control behaviors, parentemphasis (group 1) * group 1 demonstrated -12.5%*same as (1) except child-control *group 2 demonstrated -15.6%emphasis; child self management *significant decrease from pre-treatment in bothtraining (group 2) groups 1=2*adolescent in treatment alone (group1)*adolescent and mother attendedtogether (group 2) *group 1 shows -6.8% overweight* adolescent and mother attended *group 2 shows -7.0% overweightseparately (group 3) *group 3 shows -17.1% overweight
  • 28. *ten weeks from pre-treatment group 1 showed -29.5%*protein-sparing modified fast (group overweight1) *ten weeks from pre-treatment group 2 showed -13.8%*hypocaloric diet (group 2) overweight*sixteen weekly, 50-minute exercisesessions (reinforcement andmonitoring of home exercise;prescription of 20 minutes of exercise *group 1 showed -5.5 kg3-4 X per week) (group 1) *group 2 showed +2.6 kg*no exercise (group 2) *No significant change in either group
  • 29. Summary*Girls and severly obese require long-term care due to discouragmenthalfway through treatment.*Psychopathology not linked withpredicting weight loss*Parents role in treatment isextremely important for adolescent*Combining nutrition, exercise, andapplication of behavior modificationproduces most successful outcomes*Parents must be included inintervention process* Exercise must be combined withdiet to lead to weight loss
  • 30. *Boys twice as likely to substitutephysical activity than girls*Effects of study enhanced whenparticipants engage in physicalactivity to keep busy from sedentarybehaviors*Parents do need to be envolved inintervention to some degree*Variability in parent and familyfunction must be taken inconsideration for each individualcase*Well structured diet, exercise andgroup therapy are sucessful whencompined*family-based, multi-componentbehavioral interventions are effective*still needs more research

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