Childhood obesity adversely affects children’s physical and psychosocial health. Studies suggest that obesity treatment can improve children’s health. This thesis describes the process of developing and testing an intervention for overweight and obese 8-12 year old children. A systematic review, with strict parameters on the timing of outcomes and nature of comparison groups, found moderate evidence that treatment is effective compared to control and evidence was strongest for treatments based on behavioural therapy. The most widely cited programme at the time this study was developed was a behavioural treatment developed in the United States. Whilst this treatment had produced encouraging outcomes, the literature was severely limited by an absence of controlled trials and limited ethnic and social diversity in participants. The process for adapting the treatment for UK families was then described. The treatment was piloted with 33 obese children and was well received. Children attending treatment significantly reduced adiposity and experienced improved mood and self-esteem. The randomisation procedure was not tested, but the recruitment and assessment protocols appeared feasible. A randomised controlled trial was then conducted; the primary outcome was difference in BMI and BMI SDS at 6 months. 72 children were randomised (37 and 35 in the treatment and control groups respectively). Intention to treat analyses (including all children with baseline data) using baseline values where 6 month data were missing resulted in data being available for 58 children. Between-group differences in adiposity were not significant at 6 months, and there were no differences for secondary outcomes (body composition and blood pressure) and only marginal differences in exploratory analyses of psychological outcomes. The lack of a significant effect appeared due to the control group experiencing equivalent change to the treatment group. The implications and potential applications of the findings from the trial and systematic review are discussed.
| Identifer | oai:union.ndltd.org:bl.uk/oai:ethos.bl.uk:626522 |
| Date | January 2014 |
| Creators | Croker, H. |
| Publisher | University College London (University of London) |
| Source Sets | Ethos UK |
| Detected Language | English |
| Type | Electronic Thesis or Dissertation |
| Source | http://discovery.ucl.ac.uk/1425279/ |
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