Location: Children's Nutrition Research CenterTitle: Evaluation of treatment effects in obese children with co-morbid medical or psychiatric conditions Author
Submitted to: Georgian Medical News
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 1/24/2011
Publication Date: 1/24/2011
Citation: Johnston, C.A., Fullerton, G., Moreno, J.P., Tyler, C., Foreyt, J.P. 2011. Evaluation of treatment effects in obese children with co-morbid medical or psychiatric conditions. Georgian Medical News. No. 7-8(196-197):93-100. Interpretive Summary: Pediatric obesity has become an epidemic in the United States. Being obese as a child increases the risk of developing type 2 diabetes and cardiovascular disease. In order to improve lifetime risk of developing one of these conditions, effective treatments are needed to treat obesity in children. The "Traffic Light Diet" (TLD) program has been shown to be effective in treating obesity in children. However, most studies that have examined the effectiveness of the TLD have excluded children most at risk for developing type 2 diabetes and cardiovascular disease (e.g., extremely obese children and children with co-morbid conditions, such as asthma, sleep apnea, hyperinsulinemia, and psychiatric conditions). This study examined the effectiveness of the TLD in children with varying levels of obesity (e.g., severely obese, obese, and overweight) and children with and without co-morbid conditions. The results of the study indicated the TLD was effective in improving the weight outcomes of children with severe obesity and children with comorbid conditions. There was no difference in weight outcomes between children with severe obesity and obese and overweight children. Additionally weight outcomes did not differ between children with and without a co-morbid condition. Overall, this is a promising treatment, even for children who are typically excluded from clinical studies yet who are most at risk for developing conditions such as diabetes and cardiovascular disease.
Technical Abstract: The need for effective treatments for pediatric overweight is well known. We evaluated the applicability of an evidence-based treatment in an applied clinic setting that includes children with severe obesity and comorbid medical or psychiatric conditions. Forty-eight overweight children and their families were provided an evidence-based intervention at a for-profit clinic. Unlike typical lab-based samples, participants were self-selected and included children who were very overweight and/or had co-morbid conditions. Change in standardized BMI was assessed. Overall, participants demonstrated a significant reduction in standardized BMI, t (40) = 6.6, p<.001. Further analyses indicated that participants who were severely obese and children with a co-morbidity significantly reduced their zBMI (t (11) = 4.0, p < .01; t (14) = 3.9, p < .01, respectively). Children who were severely obese reduced their BMI percentile by .2 (SD = .2) and those with a co-morbidity reduced their BMI percentile by .6 (SD = .9). Nonsignificant interaction effects indicated comparable weight reductions in severely obese and overweight/obese participants, F (1,39) = 1.49, ns. Also, those with co-morbidities and those without co-morbidities experienced similar weight reductions, F (1,39) = .7, ns. This study provides promising evidence for the applicability of an evidence-based treatment for weight management in clinical practice.