The influence of preschoolers' emotional and behavioural problems on obesity treatment outcomes: Secondary findings from a randomized controlled trial

Elodie Eiffener; Karin Eli; Anna Ek; Pernilla Sandvik; Maria Somaraki; Stef Kremers; Ester Sleddens; Paulina Nowicka

doi:10.1111/ijpo.12556

The influence of preschoolers' emotional and behavioural problems on obesity treatment outcomes: Secondary findings from a randomized controlled trial

Elodie Eiffener, Karin Eli, Anna Ek, Pernilla Sandvik, Maria Somaraki, Stef Kremers, Ester Sleddens, Paulina Nowicka^*

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

BackgroundFew studies have explored the influence of preschoolers' behavioural problems on obesity treatment.

ObjectivesTo assess emotional and behavioural problems before and after an obesity intervention and examine relationships between changes in child behaviour and changes in weight status.

MethodThe study included 77 children (4-6 years old, 53% girls, mean body mass index [BMI] z-score of 3.0 [SD 0.6]) who participated in the More and Less Study, a randomized controlled trial. Families were randomized to a parenting program or to standard treatment. The children's heights and weights (BMI z-score, primary outcome) were measured at baseline and 12 months post baseline. Parents rated their children's behaviours (secondary outcome) on the Child Behavior Checklist (CBCL) for ages 1.5 to 5 years, a questionnaire that measures psychosocial health and functioning, encompassing emotional and behavioural problems. Changes in child behaviour during treatment were examined through paired samples t tests; the influence of child behaviour on treatment effects was examined through linear regressions.

ResultsChild emotional and behavioural problems significantly improved after obesity treatment. Lower scores were found for Emotional Reactivity, Sleep Problems, Affective Problems, Aggressive Behaviour, Externalizing Behaviours, Oppositional Defiant Problems, and Total Problems. Child behaviour significantly affected obesity treatment results: Attention Problems and attention deficit hyperactivity disorder (ADHD) at baseline contributed to increasing BMI z-scores, whereas Oppositional Defiant Problems, Externalizing Behaviours, and a higher number of behavioural problems predicted decreasing BMI z-scores.

ConclusionsChild behaviours at baseline influenced treatment results. Child emotional and behavioural problems improved post treatment. The results suggest that obesity treatment may help in reducing emotional distress among preschoolers.

Original language	English
Article number	e12556
Number of pages	12
Journal	Pediatric Obesity
Volume	14
Issue number	11
DOIs	https://doi.org/10.1111/ijpo.12556
Publication status	Published - Nov 2019

Keywords

ADHD
CBCL
1
5-5
Child Behavior Checklist
depression
family
parents
ATTENTION-DEFICIT/HYPERACTIVITY-DISORDER
BODY-MASS INDEX
CHILD TEMPERAMENT
ASSOCIATIONS
OVERWEIGHT
PARENTS
PSYCHOPATHOLOGY
RISK
PREDICTORS
STRESS

Access to Document

10.1111/ijpo.12556

Cite this

@article{3cb11828679848e4b106405281b54563,

title = "The influence of preschoolers' emotional and behavioural problems on obesity treatment outcomes: Secondary findings from a randomized controlled trial",

abstract = "BackgroundFew studies have explored the influence of preschoolers' behavioural problems on obesity treatment.ObjectivesTo assess emotional and behavioural problems before and after an obesity intervention and examine relationships between changes in child behaviour and changes in weight status.MethodThe study included 77 children (4-6 years old, 53% girls, mean body mass index [BMI] z-score of 3.0 [SD 0.6]) who participated in the More and Less Study, a randomized controlled trial. Families were randomized to a parenting program or to standard treatment. The children's heights and weights (BMI z-score, primary outcome) were measured at baseline and 12 months post baseline. Parents rated their children's behaviours (secondary outcome) on the Child Behavior Checklist (CBCL) for ages 1.5 to 5 years, a questionnaire that measures psychosocial health and functioning, encompassing emotional and behavioural problems. Changes in child behaviour during treatment were examined through paired samples t tests; the influence of child behaviour on treatment effects was examined through linear regressions.ResultsChild emotional and behavioural problems significantly improved after obesity treatment. Lower scores were found for Emotional Reactivity, Sleep Problems, Affective Problems, Aggressive Behaviour, Externalizing Behaviours, Oppositional Defiant Problems, and Total Problems. Child behaviour significantly affected obesity treatment results: Attention Problems and attention deficit hyperactivity disorder (ADHD) at baseline contributed to increasing BMI z-scores, whereas Oppositional Defiant Problems, Externalizing Behaviours, and a higher number of behavioural problems predicted decreasing BMI z-scores.ConclusionsChild behaviours at baseline influenced treatment results. Child emotional and behavioural problems improved post treatment. The results suggest that obesity treatment may help in reducing emotional distress among preschoolers.",

keywords = "ADHD, CBCL, 1, 5-5, Child Behavior Checklist, depression, family, parents, ATTENTION-DEFICIT/HYPERACTIVITY-DISORDER, BODY-MASS INDEX, CHILD TEMPERAMENT, ASSOCIATIONS, OVERWEIGHT, PARENTS, PSYCHOPATHOLOGY, RISK, PREDICTORS, STRESS",

author = "Elodie Eiffener and Karin Eli and Anna Ek and Pernilla Sandvik and Maria Somaraki and Stef Kremers and Ester Sleddens and Paulina Nowicka",

note = "Funding Information: We want to thank all participating families, child health care and school nurses, and all personnel involved in the standard treatment offered in the paediatric outpatient clinics. We also thank Sofia Ljung, Jonna Nyman, Mahnoush Etminan Malek, Karin Nordin, Kathryn Lewis Chamberlain, Jan Ejderhamn, Philip A. Fisher, Patricia Chamberlain, and Claude Marcus who were involved in design or in data collection in the More and Less Study. P.N. conceived the idea of this study in collaboration with E.E., A.E., E.S., and S.K. E.E. drafted the paper together with K.E. and P.S. E.E. conducted the main analyses. P.N. was responsible for the data collection and critically reviewed all analyses together with P.S., M.S., A.E., and E.S. All authors made substantial contributions to conception and design, data collection, and to interpretation of the data. All authors contributed to reviewing and approving the final manuscript. Publisher Copyright: {\textcopyright} 2019 World Obesity Federation",

year = "2019",

month = nov,

doi = "10.1111/ijpo.12556",

language = "English",

volume = "14",

journal = "Pediatric Obesity",

issn = "2047-6310",

publisher = "Wiley",

number = "11",

}

TY - JOUR

T1 - The influence of preschoolers' emotional and behavioural problems on obesity treatment outcomes

T2 - Secondary findings from a randomized controlled trial

AU - Eiffener, Elodie

AU - Eli, Karin

AU - Ek, Anna

AU - Sandvik, Pernilla

AU - Somaraki, Maria

AU - Kremers, Stef

AU - Sleddens, Ester

AU - Nowicka, Paulina

N1 - Funding Information: We want to thank all participating families, child health care and school nurses, and all personnel involved in the standard treatment offered in the paediatric outpatient clinics. We also thank Sofia Ljung, Jonna Nyman, Mahnoush Etminan Malek, Karin Nordin, Kathryn Lewis Chamberlain, Jan Ejderhamn, Philip A. Fisher, Patricia Chamberlain, and Claude Marcus who were involved in design or in data collection in the More and Less Study. P.N. conceived the idea of this study in collaboration with E.E., A.E., E.S., and S.K. E.E. drafted the paper together with K.E. and P.S. E.E. conducted the main analyses. P.N. was responsible for the data collection and critically reviewed all analyses together with P.S., M.S., A.E., and E.S. All authors made substantial contributions to conception and design, data collection, and to interpretation of the data. All authors contributed to reviewing and approving the final manuscript. Publisher Copyright: © 2019 World Obesity Federation

PY - 2019/11

Y1 - 2019/11

N2 - BackgroundFew studies have explored the influence of preschoolers' behavioural problems on obesity treatment.ObjectivesTo assess emotional and behavioural problems before and after an obesity intervention and examine relationships between changes in child behaviour and changes in weight status.MethodThe study included 77 children (4-6 years old, 53% girls, mean body mass index [BMI] z-score of 3.0 [SD 0.6]) who participated in the More and Less Study, a randomized controlled trial. Families were randomized to a parenting program or to standard treatment. The children's heights and weights (BMI z-score, primary outcome) were measured at baseline and 12 months post baseline. Parents rated their children's behaviours (secondary outcome) on the Child Behavior Checklist (CBCL) for ages 1.5 to 5 years, a questionnaire that measures psychosocial health and functioning, encompassing emotional and behavioural problems. Changes in child behaviour during treatment were examined through paired samples t tests; the influence of child behaviour on treatment effects was examined through linear regressions.ResultsChild emotional and behavioural problems significantly improved after obesity treatment. Lower scores were found for Emotional Reactivity, Sleep Problems, Affective Problems, Aggressive Behaviour, Externalizing Behaviours, Oppositional Defiant Problems, and Total Problems. Child behaviour significantly affected obesity treatment results: Attention Problems and attention deficit hyperactivity disorder (ADHD) at baseline contributed to increasing BMI z-scores, whereas Oppositional Defiant Problems, Externalizing Behaviours, and a higher number of behavioural problems predicted decreasing BMI z-scores.ConclusionsChild behaviours at baseline influenced treatment results. Child emotional and behavioural problems improved post treatment. The results suggest that obesity treatment may help in reducing emotional distress among preschoolers.

AB - BackgroundFew studies have explored the influence of preschoolers' behavioural problems on obesity treatment.ObjectivesTo assess emotional and behavioural problems before and after an obesity intervention and examine relationships between changes in child behaviour and changes in weight status.MethodThe study included 77 children (4-6 years old, 53% girls, mean body mass index [BMI] z-score of 3.0 [SD 0.6]) who participated in the More and Less Study, a randomized controlled trial. Families were randomized to a parenting program or to standard treatment. The children's heights and weights (BMI z-score, primary outcome) were measured at baseline and 12 months post baseline. Parents rated their children's behaviours (secondary outcome) on the Child Behavior Checklist (CBCL) for ages 1.5 to 5 years, a questionnaire that measures psychosocial health and functioning, encompassing emotional and behavioural problems. Changes in child behaviour during treatment were examined through paired samples t tests; the influence of child behaviour on treatment effects was examined through linear regressions.ResultsChild emotional and behavioural problems significantly improved after obesity treatment. Lower scores were found for Emotional Reactivity, Sleep Problems, Affective Problems, Aggressive Behaviour, Externalizing Behaviours, Oppositional Defiant Problems, and Total Problems. Child behaviour significantly affected obesity treatment results: Attention Problems and attention deficit hyperactivity disorder (ADHD) at baseline contributed to increasing BMI z-scores, whereas Oppositional Defiant Problems, Externalizing Behaviours, and a higher number of behavioural problems predicted decreasing BMI z-scores.ConclusionsChild behaviours at baseline influenced treatment results. Child emotional and behavioural problems improved post treatment. The results suggest that obesity treatment may help in reducing emotional distress among preschoolers.

KW - ADHD

KW - CBCL

KW - 1

KW - 5-5

KW - Child Behavior Checklist

KW - depression

KW - family

KW - parents

KW - ATTENTION-DEFICIT/HYPERACTIVITY-DISORDER

KW - BODY-MASS INDEX

KW - CHILD TEMPERAMENT

KW - ASSOCIATIONS

KW - OVERWEIGHT

KW - PARENTS

KW - PSYCHOPATHOLOGY

KW - RISK

KW - PREDICTORS

KW - STRESS

U2 - 10.1111/ijpo.12556

DO - 10.1111/ijpo.12556

M3 - Article

SN - 2047-6310

VL - 14

JO - Pediatric Obesity

JF - Pediatric Obesity

IS - 11

M1 - e12556

ER -