a Department of Psychology , Washington University in St. Louis.
J Clin Child Adolesc Psychol. 2015;44(4):521-37. doi: 10.1080/15374416.2014.963854. Epub 2014 Dec 12.
Childhood obesity is associated with increased medical and psychosocial consequences and mortality and effective interventions are urgently needed. Effective interventions are urgently needed. This article reviews the evidence for psychological treatments of overweight and obesity in child and adolescent populations. Studies were identified through searches of online databases and reference sections of relevant review articles and meta-analyses. Treatment efficacy was assessed using established criteria, and treatments were categorized as well-established, probably efficacious, possibly efficacious, experimental, or of questionable efficacy. Well-established treatments included family-based behavioral treatment (FBT) and Parent-Only Behavioral Treatment for children. Possibly efficacious treatments include Parent-Only Behavioral Treatment for adolescents, FBT-Guided Self-Help for children, and Behavioral Weight Loss treatment with family involvement for toddlers, children, and adolescents. Appetite awareness training and regulation of cues treatments are considered experimental. No treatments are considered probably efficacious, or of questionable efficacy. All treatments considered efficacious are multicomponent interventions that include dietary and physical activity modifications and utilize behavioral strategies. Treatment is optimized if family members are specifically targeted in treatment. Research supports the use of multicomponent lifestyle interventions, with FBT and Parent-Only Behavioral Treatment being the most widely supported treatment types. Additional research is needed to test a stepped care model for treatment and to establish the ideal dosage (i.e., number and length of sessions), duration, and intensity of treatments for long-term sustainability of healthy weight management. To improve access to care, the optimal methods to enhance the scalability and implementability of treatments into community and clinical settings need to be established.
儿童肥胖与增加的医疗和心理社会后果以及死亡率有关，迫切需要有效的干预措施。本文综述了针对儿童和青少年超重和肥胖的心理治疗的证据。通过在线数据库和相关综述文章和荟萃分析的参考文献部分的搜索来确定研究。使用既定标准评估治疗效果，并根据治疗效果将治疗方法分为既定、可能有效、可能有效、实验或疗效可疑。既定的治疗方法包括基于家庭的行为治疗（FBT）和仅针对父母的儿童行为治疗。可能有效的治疗方法包括仅针对父母的青少年行为治疗、FBT 指导的自助治疗儿童、以及有家庭参与的行为体重减轻治疗幼儿、儿童和青少年。食欲意识训练和调节线索治疗被认为是实验性的。没有治疗方法被认为是可能有效的，或疗效可疑的。所有被认为有效的治疗方法都是多成分干预，包括饮食和身体活动的改变，并利用行为策略。如果家庭成员在治疗中被专门针对，那么治疗效果会得到优化。研究支持使用多成分生活方式干预，FBT 和仅针对父母的行为治疗是最广泛支持的治疗类型。需要进一步研究来测试治疗的分级护理模式，并确定健康体重管理长期可持续性的理想治疗剂量（即，治疗次数和持续时间）、持续时间和强度。为了改善获得治疗的机会，需要建立最佳方法，以提高治疗的可扩展性和可实施性，并将其纳入社区和临床环境。
