Appetite Awareness Training May Enhance Behavioral Strategies in Childhood Obesity

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Participants were provided with written material regarding diet and a lifestyle physical activity program.
Participants were provided with written material regarding diet and a lifestyle physical activity program.

The addition of appetite awareness training (AAT), an approach used to encourage eating in response to hunger with satiety cues, could potentially be a maintenance enhancement strategy for family-based behavioral treatment (FBT) in childhood obesity, according to findings published in the Journal of Pediatric Psychology.

Researchers noted that prior research has shown that preschool children can be successfully trained to focus on their internal signals of hunger and fullness to improve their ability to self-regulate food intake, suggesting that approaches using this option to reduce obesity are plausible. In this study, incorporating an AAT component into FBT was evaluated in a cohort of 84 families with an obese child age 8 to 12 years. The parents were randomly assigned to either standard FBT or FBT with added AAT strategies (FBT-AAT), and the two groups were then compared.

Treatment consisted of group therapy sessions that were held separately for children and parents and single family sessions conducted over an 18-week period at an outpatient clinic. Participants also received 1 booster session at 1 year post-treatment and then a final follow-up assessment at 2 years. The primary outcome was a change in the child's standardized body mass index (BMI).

The 2 groups did not significantly differ at the end of the treatment period (P =.314), although children in the FBT-AAT group had a significantly lower standardized BMI at 1-year follow-up (P <.05), and it remained significantly lower at 2 years (P <.001).  There was also significant improvement over time in all self-reported measures (depression and anxiety), but this were similar in both groups.  In addition, there was a significant decrease in parental BMI from pre- to post-treatment, but then BMI increased significantly from post-treatment to 1-year follow-up (P <.001).

“The findings from this pilot study suggest [that] the addition of AAT to FBT is promising, but further studies should be undertaken to explore the potential added long-term benefit of including AAT in childhood obesity treatment,” wrote the investigators.

Reference

Njardvik U, Gunnarsdottir T, Olafsdottir AS, Craighead LW, Boles RE, Bjarnason

R. Incorporating appetite awareness training within family-based behavioral

<>treatment of pediatric obesity: a randomized controlled pilot study [published online July 13, 2018]. J Pediatr Psychol. doi:10.1093/jpepsy/jsy055
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