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Childhood Obesity Prevention Programs: How Do They Affect Eating Pathology and Other Psychological Measures?

From the University Department of Psychological Medicine, Christchurch School of Medicine and Health Sciences, Otago University, Christchurch, New Zealand (F.A.C.); and Departments of Psychiatry and Nutrition, University of North Caroline at Chapel Hill, Chapel Hill, North Carolina (C.M.B.).

Address correspondence and reprint requests to Frances A. Carter, Department of Psychological Medicine, Christchurch School of Medicine, PO Box 4345, Christchurch, New Zealand. E-mail: frances.carter{at}otago.ac.nz

Objectives: First, to examine how well eating pathology and other psychological measures have been assessed by childhood obesity prevention programs. Second, to evaluate the impact of these programs on eating pathology and other psychological measures.

Methods: Studies were identified in a Cochrane Collaboration review assessing the effectiveness of interventions designed to prevent obesity in childhood through the use of diet, physical activity, and/or lifestyle and social support (Summerbell C et al., Cochrane Database Syst Rev 2005:CD001871). Studies were required to be either randomized controlled trials or controlled clinical trials with a minimum duration of 12 weeks. These studies were systematically examined.

Results: Twenty-two studies were identified by the Cochrane Collaboration Review. No studies compared the rates of eating disorders or other psychiatric disorders across intervention and control groups. Symptoms of eating disorders, global measures of well being and functioning, and psychosocial variables of particular relevance to obesity such as attitudes related to food and physical activity were assessed by a minority of studies, and some measures were problematic. With the exception of one measure on one study, findings suggest that participants receiving an active intervention either did not differ significantly from the control group, or they experienced significant benefits on those psychological measures that were assessed.

Conclusions: The existing evidence does not support the view that childhood obesity prevention programs are associated with unintended psychological harm. However, because these variables have been so poorly assessed, conclusions about the possible iatrogenic effects of these programs are premature.

Key Words: obesity • overweight • prevention • childhood • eating disorders

Abbreviations: PA = physical activity; BMI = body mass index.