The influence of a behavioral weight management program on disordered eating attitudes and behaviors in children with overweight.

BACKGROUND: Behavioral interventions targeting children with overweight have been successful in facilitating weight loss; however, there is concern that these programs produce disordered eating attitudes among youth.

OBJECTIVE: The purpose of this research was to determine whether youth with overweight receiving one of two behavioral interventions were more likely to report an increase in disordered eating attitudes over time compared to a waitlist control and to determine psychosocial predictors of eating-disordered attitudes at 6-month follow-up.

DESIGN: Participants were randomized to one of two behavioral lifestyle interventions or a waitlist control. Data were collected at baseline, post-treatment, and 6-month follow-up.

PARTICIPANTS/SETTING: Participants were 68 youths with overweight, aged 8 to 13 years, and their parent(s) who lived in rural north central Florida. The project ran from January 2006 to January 2008.

INTERVENTION: Each treatment condition consisted of 12 group sessions over 16 weeks.

MAIN OUTCOME MEASURES: Parents completed a demographic form and the Child Feeding Questionnaire. Children completed the Children's Eating Attitudes Test, Schwartz Peer Victimization Scale, and Children's Body Image Scale.

STATISTICAL ANALYSES PERFORMED: Mixed 2×2 analyses of variance were used to examine the effect of treatment on eating attitudes. Hierarchical linear regression was used to assess whether baseline levels of psychosocial variables predicted disordered eating attitudes at follow-up, controlling for baseline eating attitudes and treatment condition.

RESULTS: Youth who participated in the behavioral interventions did not report significant increases in disordered eating attitudes over time compared to the waitlist control. Across all conditions, higher levels of body dissatisfaction, peer victimization, parent restrictive feeding practices, and concern for child weight at baseline predicted higher levels of disordered eating attitudes at follow-up.

CONCLUSIONS: These findings do not provide evidence that behavioral interventions lead to an increase in unhealthy eating attitudes and behaviors. Future research should examine the effects of incorporating eating disorder prevention in pediatric weight management programs.