Childhood obesity and co‐morbid problems: effects of Epstein's family‐based behavioural treatment in an Icelandic sample

• Published in: Journal of Evaluation in Clinical Practice
• Main Authors: Gunnarsdottir, Thrudur, Njardvik, Urdur, Olafsdottir, Anna S., Craighead, Linda, Bjarnason, Ragnar
• Format: Article in Journal/Newspaper
• Language: English
• Published: Wiley 2011
• Subjects: Iceland
• Online Access: http://dx.doi.org/10.1111/j.1365-2753.2010.01603.x; https://api.wiley.com/onlinelibrary/tdm/v1/articles/10.1111%2Fj.1365-2753.2010.01603.x; https://onlinelibrary.wiley.com/doi/pdf/10.1111/j.1365-2753.2010.01603.x

Abstract Objective This study assessed the effects of Epstein's family‐based behavioural treatment in a clinical sample of obese children in Iceland. Also, it explored whether co‐morbid concerns affect treatment outcome. Methods Eighty‐four obese children [mean body‐mass‐index standard‐deviation‐scores (BMI‐SDS) = 3.11, aged 7.5–13.6 years] and a participating parent initiated treatment in response to a school‐based screening. Sixty‐one families completed treatment and were followed for 1 year post treatment. Measurements included height, weight, reports of psychological well‐being (Strengths and Difficulties Questionnaire, Multidimensional Anxiety Scale for Children, Children's Depression Inventory, Piers–Harris Self Concept Scale, Social Skills Rating System) and academic competencies. Results Among treatment completers a large effect size was obtained for change in BMI‐SDS during treatment (mean difference = −0.40, SD = 0.29). Psychological well‐being improved and treatment effects were maintained at 1‐year follow‐up. At baseline, 69% of the children presented with one or more co‐morbid concerns. Children who scored above cut‐off for concern on parent‐reported hyperactivity (Strengths and Difficulties Questionnaire subscale T ‐score ≥ 65) reduced their BMI‐SDS less during treatment than children with lower hyperactivity scores whereas children who scored in the clinical range for social anxiety (Multidimensional Anxiety Scale for Children subscale T ‐score ≥ 65) reduced their BMI‐SDS significantly more than children with lower social anxiety scores. The social anxiety effect was still present at 1‐year follow‐up, but not the hyperactivity effect ( P > 0.05). No differential response was shown for children with higher depression scores, lower self‐concept or low academic competencies. Conclusions Epstein's family‐based behavioural treatment produced promising effects in both the short and the longer term in a clinical sample of Icelandic children with substantial rates of co‐morbid concerns. Co‐morbid ...