Tratamiento integral de la obesidad infantil: Efecto de una intervención psicológica / Effects of psychological support as an adjunct to a weight reducing program among obese children

Background: Disrupted eating behaviors and psychological issues can have a role in the development of childhood obesity. Aim: To assess the effects of psychological support as an adjunct to the treatment of obesity among children. Material and Methods: Retrospective analysis of a group of 152 obese children aged 3 to 16 years, who received medical, Nutritional and physical training treatment. Seventy three (Group I) were invited to participate in a protocol of psychological support and 79 formed the control group (Group 2). Body mass index, body fat mass, waist circumference, insulin sensitivity, lipid profile, eating and physical activity habits were evaluated. Family structure, history of food rejection, psychological, physical and social development, and adherence to the program were also analyzed. To analyze responses to treatment, Group I was further divided into those who attended the psychology sections (intervened group) and those who did not attend (non intervened group). Results: At baseline, there were no differences in anthropometric, metabolic, familial and psychological profile among Groups I and 2. Family structure, eating behaviors and physical and social development were normal. Those associated with lack of control appeared as negative characteristics. There was a significant improvement in eating habits and physical activity among intervened children of Group 1 and Group 2. No significant change in weight was recorded in all three groups. Compliance with the program was significantly better among intervened children in Group 1 (62.1 percent at sixth months), compared with non intervened children of Group 1 (15.9 percent) and Group 2 (30.3 percent). Conclusions: Obese children who attended psychological support therapy as an adjunct to a weight reducing program, had a better compliance with treatment but did not achieve a higher weight loss.

[Effects of psychological support as an adjunct to a weight reducing program among obese children]. / Tratamiento integral de la obesidad infantil: Efecto de una intervención psicológica.

BACKGROUND: Disrupted eating behaviors and psychological issues can have a role in the development of childhood obesity. AIM: To assess the effects of psychological support as an adjunct to the treatment of obesity among children. MATERIAL AND METHODS: Retrospective analysis of a group of 152 obese children aged 3 to 16 years, who received medical, Nutritional and physical training treatment. Seventy three (Group I) were invited to participate in a protocol of psychological support and 79 formed the control group (Group 2). Body mass index, body fat mass, waist circumference, insulin sensitivity, lipid profile, eating and physical activity habits were evaluated. Family structure, history of food rejection, psychological, physical and social development, and adherence to the program were also analyzed. To analyze responses to treatment, Group I was further divided into those who attended the psychology sections (intervened group) and those who did not attend (non intervened group). RESULTS: At baseline, there were no differences in anthropometric, metabolic, familial and psychological profile among Groups I and 2. Family structure, eating behaviors and physical and social development were normal. Those associated with lack of control appeared as negative characteristics. There was a significant improvement in eating habits and physical activity among intervened children of Group 1 and Group 2. No significant change in weight was recorded in all three groups. Compliance with the program was significantly better among intervened children in Group 1 (62.1% at sixth months), compared with non intervened children of Group 1 (15.9%) and Group 2 (30.3%). CONCLUSIONS: Obese children who attended psychological support therapy as an adjunct to a weight reducing program, had a better compliance with treatment but did not achieve a higher weight loss.

Problemas de rechazo alimentario en lactantes / Food rejection in infants

Las dificultades de alimentación en los niños, frecuentemente referidas al rechazo a alimentarse, constituyen un motivo de consulta frecuente a nivel pediátrico. Estos problemas constituyen un riesgo para el desarrollo del niño(a), ya que no sólo se asocian con trastornos del crecimiento y desarrollo, sino que también con problemas conductuales y trastornos de la alimentación en la niñez y adolescencia. En Chile no existen estudios de incidencia y prevalencia de estas dificultades. Con el objetivo de aproximarnos al estudio de estas dificultades se diseñó una encuesta de alimentación, en la cual se evaluó la presencia de rechazo alimentario, el tipo de rechazo, desde cuando se presenta el problema y a que se atribuye esta dificultad. La encuesta se aplicó a madres de lactantes, de 4 a 24 meses de edad, que participan en un programa de intervención nutricional desarrollado en el INTA. De un total de 511 madres encuestadas el 23 por ciento refirió dificultad de alimentación en su hijo(a). Se apreció una mayor proporción de rechazo alimentario en lactantes entre 6 y 8 meses (30,8 por ciento) y mayores de 12 meses (33,6 por ciento). Como principal problema se reportó el rechazo selectivo de alimentos (46,5 por ciento), en segundo lugar aquellas dificultades en las cuales se logra la ingesta pero con gran esfuerzo de parte de la madre (28,9 por ciento) y por último aquellos problemas en que se logra la mitad o menos de la ingesta de alimentos (24,6 por ciento). Los resultados coinciden con los reportes de prevalencia que aparecen en la literatura; cuando el problema es identificado como tal por los padres la prevalencia es de alrededor de un 20 por ciento a 30 por ciento. Estos antecedentes confirman la necesidad de profundizar en el estudio de estas dificultades; incrementar el conocimiento existente respecto de los factores involucrados en la presencia y mantención del problema, así como en el desarrollo de modelos orientados tanto a su prevención como tratamiento