Cognitive behavioral therapy improves diet and body composition in overweight and obese adolescents.

BACKGROUND

Cognitive behavioral therapy (CBT) teaches behavioral and cognitive strategies that focus on achieving and maintaining lifestyle changes.

OBJECTIVE

We examined the effectiveness of a CBT program (CHOOSE HEALTH) for improving body composition, diet, and physical activity in overweight and obese adolescents.

DESIGN

Adolescents [16 male, 31 female; aged 14.5 +/- 1.6 y; body mass index (BMI; in kg/m(2)) 30.9 +/- 4.2] were block-matched into 2 groups by age, sex, Tanner stage, BMI, and hip and waist circumferences and were randomly assigned to CBT or no treatment (control). CBT consisted of 10 weekly sessions, followed by 5 fortnightly telephone sessions.

RESULTS

Compared with the control, over 20 wk, CBT improved (significant group x time interactions) BMI (CBT, -1.3 +/- 0.4; control, 0.3 +/- 0.3; P = 0.007), weight (CBT, -1.9 +/- 1.0 kg; control, 3.8 +/- 0.9 kg; P = 0.001), body fat (CBT, -1.5 +/- 0.9 kg; control, 2.3 +/- 1.0 kg; P = 0.001), and abdominal fat (CBT, -124.0 +/- 46.9 g; control, 50.1 +/- 53.5 g; P = 0.008). CBT showed a greater reduction in intake of sugared soft drinks as a percentage of total energy (CBT, -4.0 +/- 0.9%; control, -0.3 +/- 0.9%; P = 0.005 for group x time interaction), which was related to reductions in weight (r = 0.48, P = 0.04), BMI (r = 0.53, P = 0.02), and waist circumference (r = 0.54, P = 0.02). Physical activity did not change significantly.

CONCLUSIONS

A 10-wk CBT program followed by 10 wk of fortnightly phone contact improved body composition in overweight and obese adolescents. Changes in soft drink consumption may have contributed to this benefit.