July 13, 2012
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Group-based cognitive behavioral therapy found effective in reducing obesity in adolescents

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Group-based cognitive-behavioral therapy combined with aerobic exercise or peer-based adventure therapy was effective at maintaining reductions in adolescent obesity and improvements in adolescents’ perception of their own physical appearance and social acceptance, according to study results.

Elizabeth E. Lloyd-Richardson, PhD, assistant professor of psychiatry and human behavior at Brown Medical School, and colleagues conducted a randomized controlled trial of 118 obese adolescents aged 13 to 16 years. Participants were randomly assigned to receive the same 16-week group-based cognitive-behavioral therapy (CBT), combined with either aerobic exercise or peer-based adventure therapy, which is derived from the principles of Outward Bound and designed to increase teamwork, social skills and self-efficacy.

Doctoral-level psychologists experienced in adolescent weight management conducted treatment groups. CBT intervention involved physical activity prescription, nutrition intervention and behavior modification. Nutrition intervention consisted of a balanced-deficit diet of 1,400 to 1,600 calories. Participants’ weight and height were measured using a balance beam scale and stadiometer, and the researchers used the Self-Perception Profile for Adolescents to assess participants’ perceptions of competence, including athletic competence, physical appearance, global self-worth and social acceptance. Self-efficacy, or the individual’s belief in his or her ability to succeed in specific situations, was measured using the Weight Efficacy Life-Style Questionnaire and the Physical Self-Efficacy Questionnaire.

Intent-to-treat analysis showed “a significant effect for time on both percent over 50th percentile BMI for age and gender and standardized BMI score, with no differences by intervention group,” the researchers wrote. There was significant decrease in BMI at 4 months (P<.001), which was maintained at both 12- and 24-month follow-ups. Results also showed significant improvements over time in participants’ perception of their physical appearance (P<.001), social acceptance (P<.05) and global self-worth (P<.05). There were no significant changes in self-efficacy.

“The clinical implications of this research are clear,” the researchers wrote. “Comprehensive intervention, including dietary and physical activity prescription along with behavioral modifications, can be effective in reducing weight status in obese adolescents.”

Disclosure: The researchers report no relevant financial disclosures.