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American Journal of Clinical Nutrition, Vol. 87, No. 5, 1134-1140, May 2008
© 2008 American Society for Nutrition

ORIGINAL RESEARCH COMMUNICATION

Cognitive behavioral therapy improves diet and body composition in overweight and obese adolescents1,2,3

Margarita D Tsiros1, Natalie Sinn1, Leah Brennan1, Alison M Coates1, Jeff W Walkley1, John Petkov1, Peter RC Howe1 and Jonathan D Buckley1

1 From the Australian Technology Network Centre for Metabolic Fitness (MDT, NS, LB, AMC, JWW, PRCH, and JDB) and the Nutritional Physiology Research Centre (MDT, NS, AMC, PRCH, and JDB), School of Health Sciences, University of South Australia, Adelaide, Australia; the School of Medical Sciences, RMIT University, Melbourne, Australia (JWW and LB); the Parenting Research Centre, Melbourne, Australia (LB); and the Centre for Regional Engagement, University of South Australia, Adelaide, Australia (JP)

Background:Cognitive behavioral therapy (CBT) teaches behavioral and cognitive strategies that focus on achieving and maintaining lifestyle changes.

Objective:We examined the effectiveness of a CBT program (CHOOSE HEALTH) for improving body composition, diet, and physical activity in overweight and obese adolescents.

Design:Adolescents [16 male, 31 female; aged 14.5 ± 1.6 y; body mass index (BMI; in kg/m2) 30.9 ± 4.2] were block-matched into 2 groups by age, sex, Tanner stage, BMI, and hip and waist circumferences and were randomly assigned to CBT or no treatment (control). CBT consisted of 10 weekly sessions, followed by 5 fortnightly telephone sessions.

Results:Compared with the control, over 20 wk, CBT improved (significant group x time interactions) BMI (CBT, –1.3 ± 0.4; control, 0.3 ± 0.3; P = 0.007), weight (CBT, –1.9 ± 1.0 kg; control, 3.8 ± 0.9 kg; P = 0.001), body fat (CBT, –1.5 ± 0.9 kg; control, 2.3 ± 1.0 kg; P = 0.001), and abdominal fat (CBT, –124.0 ± 46.9 g; control, 50.1 ± 53.5 g; P = 0.008). CBT showed a greater reduction in intake of sugared soft drinks as a percentage of total energy (CBT, –4.0 ± 0.9%; control, –0.3 ± 0.9%; P = 0.005 for group x time interaction), which was related to reductions in weight (r = 0.48, P = 0.04), BMI (r = 0.53, P = 0.02), and waist circumference (r = 0.54, P = 0.02). Physical activity did not change significantly.

Conclusions:A 10-wk CBT program followed by 10 wk of fortnightly phone contact improved body composition in overweight and obese adolescents. Changes in soft drink consumption may have contributed to this benefit.






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