Evidence Update on the Treatment of Overweight and Obesity in Children and Adolescents
Evidence Update on the Treatment of Overweight and Obesity in Children and Adolescents
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DOI：
10.1080/15374416.2014.963854
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发表时间：
2015-07-04
影响因子：
4.2
通讯作者：
Wilfley, Denise E.
中科院分区：
文献类型：
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作者：
Altman, Myra;Wilfley, Denise E.
儿童肥胖与医疗和社会心理后果以及死亡率增加有关，迫切需要有效的干预措施。迫切需要有效的干预措施。本文回顾了儿童和青少年人群超重和肥胖心理治疗的证据。研究是通过搜索在线数据库以及相关评论文章的参考部分和荟萃分析来确定的。使用既定标准评估治疗效果，并将治疗分为成熟的、可能有效的、可能有效的、实验性的或疗效可疑的。成熟的治疗方法包括基于家庭的行为治疗（FBT）和针对儿童的仅限家长的行为治疗。可能有效的治疗方法包括针对青少年的仅限家长的行为治疗、针对儿童的 FBT 引导自助以及针对幼儿、儿童和青少年的家庭参与的行为减肥治疗。食欲意识训练和线索治疗调节被认为是实验性的。没有任何治疗被认为可能有效或功效值得怀疑。所有被认为有效的治疗都是多方面的干预措施，包括饮食和身体活动的改变以及利用行为策略。如果家庭成员有针对性地接受治疗，治疗就会得到优化。研究支持使用多种生活方式干预措施，其中 FBT 和仅限家长的行为治疗是最广泛支持的治疗类型。需要进行更多研究来测试治疗的阶梯式护理模式，并确定理想的剂量（即疗程的次数和时长）、持续时间和治疗强度，以实现健康体重管理的长期可持续性。为了改善获得护理的机会，需要建立最佳方法来增强社区和临床环境中治疗的可扩展性和可实施性。
Childhood obesity is associated with increased medical and psychosocial consequences and mortality and effective interventions are urgently needed. Effective interventions are urgently needed. This article reviews the evidence for psychological treatments of overweight and obesity in child and adolescent populations. Studies were identified through searches of online databases and reference sections of relevant review articles and meta-analyses. Treatment efficacy was assessed using established criteria, and treatments were categorized as well-established, probably efficacious, possibly efficacious, experimental, or of questionable efficacy. Well-established treatments included family-based behavioral treatment (FBT) and Parent-Only Behavioral Treatment for children. Possibly efficacious treatments include Parent-Only Behavioral Treatment for adolescents, FBT-Guided Self-Help for children, and Behavioral Weight Loss treatment with family involvement for toddlers, children, and adolescents. Appetite awareness training and regulation of cues treatments are considered experimental. No treatments are considered probably efficacious, or of questionable efficacy. All treatments considered efficacious are multicomponent interventions that include dietary and physical activity modifications and utilize behavioral strategies. Treatment is optimized if family members are specifically targeted in treatment. Research supports the use of multicomponent lifestyle interventions, with FBT and Parent-Only Behavioral Treatment being the most widely supported treatment types. Additional research is needed to test a stepped care model for treatment and to establish the ideal dosage (i.e., number and length of sessions), duration, and intensity of treatments for long-term sustainability of healthy weight management. To improve access to care, the optimal methods to enhance the scalability and implementability of treatments into community and clinical settings need to be established.