Levine M D, Ringham R M, Kalarchian M A, Wisniewski L, Marcus M D
Department of Psychiatry, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.
Int J Eat Disord. 2001 Nov;30(3):318-28. doi: 10.1002/eat.1091.
Although the efficacy of family-based behavioral treatment for moderate pediatric obesity has been well established, few studies have focused on the treatment of severe obesity. We sought to evaluate the acceptability and feasibility of a family-based intervention for severely obese children.
Twenty-four families with children aged 8-12 years who were > or =160% of their ideal body weight participated in a 10-12-session behavioral intervention. Participants were weighed and their heights measured at the start of each treatment session and during a follow-up visit 4-13 (M = 7.8) months posttreatment. Children also completed measures of depressive symptoms and anxiety at pretreatment, posttreatment, and follow-up, and eating attitudes were assessed at pretreatment and follow-up.
One third of the families did not complete treatment. However, children who completed the program lost a significant amount of weight and reported significant improvements in depression, anxiety, and eating attitudes that were maintained over time.
A short-term, family-based behavioral intervention was successful in moderating weight gain for most children and had positive effects on children's mood and eating disorder symptoms. Future randomized, controlled trials of longer interventions are necessary to determine the success of this approach.
尽管基于家庭的行为疗法对中度小儿肥胖症的疗效已得到充分证实，但很少有研究关注重度肥胖症的治疗。我们试图评估针对重度肥胖儿童的家庭干预措施的可接受性和可行性。
24个家庭参与了一项为期10 - 12节的行为干预，这些家庭的孩子年龄在8至12岁之间，体重超过理想体重的160%。在每次治疗开始时以及治疗后4至13个月（平均7.8个月）的随访中测量参与者的体重和身高。儿童还在治疗前、治疗后和随访时完成抑郁症状和焦虑的测量，在治疗前和随访时评估饮食态度。
三分之一的家庭未完成治疗。然而，完成该项目的儿童体重显著减轻，并且报告称抑郁、焦虑和饮食态度有显著改善，且这些改善随着时间得以维持。
短期的基于家庭的行为干预对大多数儿童控制体重增加是成功的，并且对儿童的情绪和饮食失调症状有积极影响。未来有必要进行更长时间干预的随机对照试验，以确定这种方法是否成功。
