Managing lipid disorders in children—a special pediatric section
Promoting healthy lifestyles: Behavior modification and motivational interviewing in the treatment of childhood obesity

https://doi.org/10.1016/j.jacl.2008.03.003Get rights and content

Abstract

Childhood obesity has increased dramatically during the past two decades. The growing incidence of childhood obesity is alarming, given the significant short- and long-term health consequences associated with obesity and the strong tracking of obesity from childhood to adulthood. Lifestyle plays an important role in the development and maintenance of obesity. Behavior modification programs targeting eating, exercise, and diet behaviors continue to be the mainstay for treating obese children. Although family-based behavioral weight management programs have resulted in significant improvements in weight status, maintaining improvements in weight status continues to be a challenge, with many interventions resulting in considerable relapse. Motivational interviewing is one innovative approach, used alone or in conjunction with standard behavioral modification programs, which has been proposed to have the potential to enhance motivation for change and therefore improve long-term treatment outcomes for obese children. A broad literature search using two electronic databases, Medline and PsycINFO, to identify studies that used an intervention with a motivational interviewing component to modify diet and/or physical activity in the prevention or treatment of childhood obesity identified two studies that targeted weight as a primary outcome. The studies reviewed indicate that, although initial findings are encouraging, further research is needed to determine the effectiveness of motivational interviewing for prevention and treatment of childhood obesity. Concerted efforts are clearly needed to elucidate the mechanisms for maintenance of initial treatment gains, as well as the ultimate achievement of more ideal weight once formal treatment ceases.

Section snippets

Health-related quality of life and childhood obesity

A number of authors have argued that improving quality of life is the ultimate goal of health care.15, 16 Health-related quality of life (HRQOL) has emerged as the most appropriate term for quality-of-life dimensions that represent a patient's perceptions of the impact of an illness and its treatment on their own functioning and well-being and which are thus within the scope of health care services and medical products.17, 18 HRQOL is a multidimensional construct, consisting at the minimum of

Discussion

Family-based behavior-modification programs targeting eating, exercise, and diet behaviors have resulted in significant short-term improvements in weight status for obese children. The major challenge in the treatment of childhood obesity is ensuring long-term maintenance of behavior change, including adherence to a prudent diet plan, appropriate eating behavior, and regular exercise. Concerted efforts are clearly needed to elucidate the mechanisms for maintenance of initial treatment gains, as

Conclusion

Lifestyle behaviors are strongly associated with childhood obesity. Although behavior-modification programs targeting eating, exercise, and diet behaviors have resulted in significant improvements in weight status, increased physical fitness, and psychosocial benefits for obese children, ensuring long-term maintenance of these behavior changes continues to be a challenge. Greater research attention should be directed at understanding what motivates children and their families to initiate

Financial disclosure

This work was supported by an intramural grant from the Texas A&M University Research Foundation, College Station, TX.

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