Effects of diet plus exercise on weight change in parents and children.

Obese children (aged 8–12 yrs) and parents from 53 families were randomly assigned to 3 groups: diet, diet plus exercise, and no-treatment control. At 6 mo, parents and children in both treatment groups had equal and significantly better weight change than members of the control group. At 1 yr, however, parents given diet plus exercise showed better weight losses than parents given diet alone. No treatment group differences were found for children after 1 yr. Parent and child weight changes observed during the 1st 6 mo of treatment were highly correlated, but those observed during Months 6–22 were uncorrelated. Discriminant analyses showed that initial relative weight was the best predictor of 12-mo relative weight for both parents and children but that exposure to the exercise program during treatment was a predictor of maintenance of nonobesity. (23 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Child and parent weight loss in family-based behavior modification programs.

Overweight preadolescents and parents from 76 families were assigned to 1 of 3 behavioral treatment groups: parent/child target, child target, or nonspecific target. Percent overweight changes at the end of the 8-mo treatment and 13-mo follow-up were equivalent for children in the 3 treatment groups, but parents in the parent/child group lost more weight during treatment. Weight changes for parents and children increased through the 8-mo treatment. Patterns of maintenance showed that 40% of the children were within 20% of their ideal weight by the end of treatment, achieving nonobese status. 100% of the newly nonobese children in the parent/child group maintained nonobesity during follow-up, whereas only 30% in the child-alone group and 33% in the nonspecific group maintained nonobesity. In addition, weight losses for parents and children in the same family correlated positively at the end of treatment but not at follow-up. Results suggest that parental modeling may be important during treatment, but long-term results probably are due to parental reinforcement of child self-regulation. (30 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effect of obesity on the response to insulin therapy in noninsulin-dependent diabetes mellitus

An initial improvement in glycemic control is often followed by gradual deterioration of glycemia during insulin treatment of patients with noninsulin-dependent diabetes mellitus (NIDDM). We examined the causes of such worsening in a 12-month follow-up analysis of 100 insulin-treated NIDDM patients in the Finnish Multicenter Insulin Therapy Study who were treated with either combination therapy with insulin or insulin alone. In the entire study group, glycemic control averaged 9.7 +/- 0.2% at 0 months and 8.0 +/- 0.1%, 8.0 +/- 0.1%, 8.2 +/- 0.1%, and 8.5 +/- 0.2% at 3, 6, 9, and 12 months (P < 0.001 for each time point vs. 0 months). Glycemic control at 12 months was significantly worse than that at 3 (P < 0.001), 6 (P < 0.001), and 9 months (P < 0.02). Baseline body mass index was the most significant predictor of deterioration in glycemic control. During 1 yr, hemoglobin A1c decreased almost 3-fold more (by 1.7 +/- 0.2%; P < 0.001 vs. 0 months) in patients whose baseline weight was below the mean baseline body mass index of 28.1 kg/m2 (nonobese patients) than in those whose weight exceeded 28.1 kg/m2 (obese patients; 0.5 +/- 0.2%; P = NS vs. 0 months; P < 0.01 vs. obese patients). Glycemic control improved similarly over 1 yr in the nonobese subjects and deteriorated similarly in the obese patients regardless of their treatment regimen. Insulin doses, per body weight, were similar in the nonobese and obese patients. The nonobese patients consistently gained less weight during 12 months of combination therapy with insulin (3.5 +/- 0.6 kg at 12 months) than during insulin therapy alone (5.1 +/- 0.6 kg; P < 0.05). The treatment regimen did not influence weight gain in the obese group, who gained 4.4 +/- 1.0 kg during combination therapy with insulin and 4.5 +/- 1.1 kg during insulin therapy alone. We reached the following conclusions: 1) after an initial good response, glycemic control deteriorates more in obese than in nonobese patients with NIDDM; 2) in obese patients, weight gain per se cannot explain the poor glycemic response to combination or insulin therapy, but it may induce a disproportionately large increase in insulin requirements because of greater insulin resistance in the obese than in the nonobese; 3) in nonobese patients, glycemic control improves equally during 1 yr with combination therapy with insulin and insulin alone, but combination therapy with insulin is associated with less weight gain than treatment with insulin alone; 4) weight gain appears harmful, as it is associated with increases in blood pressure and low density lipoprotein cholesterol.     

Long-term effects of family-based treatment of childhood obesity.

This study was a 5-year follow-up of obese children who participated in a family-based behavioral weight-control program targeting and reinforcing children and parents for weight loss (Epstein, Wing, Koeske, Andrasik, & Ossip, 1981). Children in the parent-plus-child group showed significantly greater weight reductions after 5 years (–22.7% overweight) than did children in a child-alone target group or in a no-target control group (4.3% and 8.2% overweight, respectively). One third of children in the parent-plus-child group were within 20% of normal weight in comparison with 5% of the children in the no-target control group. Height percentile decreased from the 72nd to the 60th percentile; these changes were negatively related to weight change. These children remained taller than the average child after weight loss, and children of short and medium-height parents were still relatively taller than their parents after 5 years. (23 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Child and family coping one year after mediated and litigated child custody disputes.

Evaluated child and family outcomes 1 yr after parents had used mediation (n?=?32) or litigation (n?=?26) to settle custody disputes over children aged 2–17 yrs. One year after settlement, parents in mediation showed greater correspondence in perceptions of the settlement process and of their child's problems. Contrary to expectations, there was a greater association between parent and child problems among families in mediation. Child outcomes did not differ in the mediation and litigation groups but did differ according to the level of parental conflict. Custody settlements that promote ongoing contact between parents after divorce may offer both rewards and risks. Children can benefit when the parents' relationship is cooperative, but may suffer when the parents continue to fight. More intensive intervention may be needed to help parents maintain generational boundaries and shelter their children from conflict after divorce. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Prognostic implications of p53 overexpression in cutaneous melanoma from sun-exposed and nonexposed sites

Reduced energy expenditure may predispose children to the development of obesity, but there are limited longitudinal studies to support this theory. We studied 75 white, preadolescent children over 4 y by taking annual measures of body composition and resting energy expenditure (by indirect calorimetry) and two annual measures of total energy expenditure and physical-activity-related energy expenditure (by doubly labeled water). Body composition of parents was assessed at the onset of the study with use of underwater weighing. The major outcome variable was the individual rate of change in fat mass (FM) adjusted for fat-free mass (FFM). The influence of sex, energy expenditure components, initial FM, and parental FM on the rate of change in FM was analyzed by hierarchical linear modeling and analysis of variance. The rate of change in absolute FM was 0.89 +/- 1.08 kg/y (range: -0.44 to 5.6 kg/y). The rate of change in FM adjusted for FFM was 0.08 +/- 0.64 kg/y (range: -1.45 to 2.22 kg/y) and was similar among children of two nonobese parents and children with one nonobese or one obese parent, but was significantly higher in children with two obese parents (0.61 +/- 0.87 kg/y). The major determinants of change in FM adjusted for FFM were sex (greater fat gain in girls), initial fatness, and parental fatness. None of the components of energy expenditure were inversely related to change in FM. The main predictors of change in FM relative to FFM during preadolescent growth are sex, initial fatness, and parental fatness, but not reduced energy expenditure.     

The effect of increasing initial weight loss with the Scarsdale Diet on subsequent weight loss in a behavioral treatment program.

20 overweight Ss (aged 20–65 yrs) who participated in a behavioral weight control program that included 2 wks on the Scarsdale diet lost more weight during that period than did 19 Ss in a behavioral group without the diet. The experimental manipulation of initial weight loss did not significantly affect subsequent or overall weight loss. At 1 yr, the average weight losses of the Scarsdale and behavioral conditions were not significantly different. (3 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

"Child and Parent Weight Loss in Family-Based Behavior Modification Programs": Correction to Epstein et al.

Reports an error in the original article by Leonard H. Epstein, Rena R. Wing, Randi Koeske, Frank Andrasik, and Deborah J. Ossip (Journal of Consulting and Clinical Psychology, 1981, 49, 674-685). There are several errors in Table 3. The corrected table is provided. (The following abstract of this article originally appeared in record 1982-01694-001.) Overweight preadolescents and parents from 76 families were assigned to 1 of 3 behavioral treatment groups: parent/child target, child target, or nonspecific target. Percent overweight changes at the end of the 8-mo treatment and 13-mo follow-up were equivalent for children in the 3 treatment groups, but parents in the parent/child group lost more weight during treatment. Weight changes for parents and children increased through the 8-mo treatment. Patterns of maintenance showed that 40% of the children were within 20% of their ideal weight by the end of treatment, achieving nonobese status. 100% of the newly nonobese children in the parent/child group maintained nonobesity during follow-up, whereas only 30% in the child-alone group and 33% in the nonspecific group maintained nonobesity. In addition, weight losses for parents and children in the same family correlated positively at the end of treatment but not at follow-up. Results suggest that parental modeling may be important during treatment, but long-term results probably are due to parental reinforcement of child self-regulation. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Behavior change, weight loss, and physiological improvements in Type II diabetic patients.

53 obese 30–70 yr olds with Type 2 diabetes treated by diet only or oral medication were assigned to a behavior-modification, nutrition-education, or standard-care treatment condition to investigate whether behavior modification would improve short- and long-term results of weight control programs for Ss. The behavior-modification and nutrition-education groups met weekly for 16 wks and were given the same information on nutrition, exercise, and diabetes; however, strategies to change eating behavior were used in the behavior-modification condition. The standard-care condition was identical to the nutrition-education condition except that Ss met only 4 times over the 16-wk treatment period. Results indicate that behavior-modification Ss lost more weight than either the nutrition-education or standard-care Ss during the 16-wk treatment period. However, at 16-mo follow-up, differences in weight loss across treatment conditions were not significant. Physiological parameters and mood improved with initial weight loss, but these changes were not maintained. Physiological changes appeared more directly related to weight loss than to treatment condition. Changes in weight were related to improved eating and exercise habits, and modest weight losses of 4.6–23.6 kg produced significant improvements in blood-sugar control. (46 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Ten-year outcomes of behavioral family-based treatment for childhood obesity.

Reports 10-yr treatment outcomes for obese children in 4 randomized treatment studies. At 10 yrs, 34% decreased percentage overweight by 20% or more, and 30% were not obese. Significant effects were observed when parents and children were targeted and reinforced for weight loss in comparison with nontargeted controls and for children given lifestyle or aerobic exercise in comparison with a calisthenics control. 34% of the variance in change in percentage overweight was predicted from sex, baseline percentage overweight, self-monitoring weight, meals eaten at home, and family and friends' support for eating and exercise. Results show long-term changes in children depend on the treatment, and evidence converges on the importance of the family and other sources of support for eating and activity change. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The effect of family variables on child weight change.

Analyzed the effects of family variables (e.g., family size, family weight composition, parental weight) on child weight loss in a series of family-based, behaviorally oriented weight control programs for children from 102 families. Results show that the amount of relative weight change was related to initial treatment success, the number of children in the family, and the gender of the child. Children who were more successful lost more weight initially, had fewer siblings, and were female. It is suggested that family size may interact with treatment to determine weight change, possibly by reducing the amount of time a parent has to spend promoting behavior change or the effectiveness of parents in managing their children. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effect of calories on appetite for palatable food in obese and nonobese humans.

In 3 experiments, palatable food stimuli were presented to 11 obese and 11 nonobese male human Ss (mean age 24.5 yrs) 1 hr after ingestion of 900-calorie liquid lunches and (on separate days) identically tasting 450-calorie liquid lunches of equal volume. Salivary responses to the presentation of the stimuli (i.e., appetite) by the nonobese were inhibited by the high-calorie meal, but those by the obese were less inhibited. Hunger ratings were unaffected by calories in either group. Food stimuli were rated as more appetizing by the nonobese after low-calorie than after high-calorie meals, but not so by the obese. Parallels with animal findings suggest that salivary responses reflect lateral hypothalamic activity. (22 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Long-term effects of sudden bereavement: Marital and parent-child relationships and children's reactions.

Explored long-term family adjustment to sudden, unexpected bereavement by conducting interviews with 40 Ss whose spouse died in a motor vehicle crash 4–7 yrs earlier and with 39 matched controls. Interviews were also conducted with 54 parents whose 1–28 yr old child died in a motor vehicle crash 4–7 yrs earlier and with 61 matched controls. Findings indicate that marital relationships generally strengthened or dissolved after a child's death. Most bereaved adults reported feeling closer to their children after the loss of a family member. Parental reports suggest that the death of a parent or sibling is overwhelmingly negative for children, and extremely so for a significant percentage. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Predicting obesity in young adulthood from childhood and parental obesity

BACKGROUND: Childhood obesity increases the risk of obesity in adulthood, but how parental obesity affects the chances of a child's becoming an obese adult is unknown. We investigated the risk of obesity in young adulthood associated with both obesity in childhood and obesity in one or both parents. METHODS: Height and weight measurements were abstracted from the records of 854 subjects born at a health maintenance organization in Washington State between 1965 and 1971. Their parents' medical records were also reviewed. Childhood obesity was defined as a body-mass index at or above the 85th percentile for age and sex, and obesity in adulthood as a mean body-mass index at or above 27.8 for men and 27.3 for women. RESULTS: In young adulthood (defined as 21 to 29 years of age), 135 subjects (16 percent) were obese. Among those who were obese during childhood, the chance of obesity in adulthood ranged from 8 percent for 1- or 2-year-olds without obese parents to 79 percent for 10-to-14-year-olds with at least one obese parent. After adjustment for parental obesity, the odds ratios for obesity in adulthood associated with childhood obesity ranged from 1.3 (95 percent confidence interval, 0.6 to 3.0) for obesity at 1 or 2 years of age to 17.5 (7.7 to 39.5) for obesity at 15 to 17 years of age. After adjustment for the child's obesity status, the odds ratios for obesity in adulthood associated with having one obese parent ranged from 2.2 (95 percent confidence interval, 1.1 to 4.3) at 15 to 17 years of age to 3.2 (1.8 to 5.7) at 1 or 2 years of age. CONCLUSIONS: Obese children under three years of age without obese parents are at low risk for obesity in adulthood, but among older children, obesity is an increasingly important predictor of adult obesity, regardless of whether the parents are obese. Parental obesity more than doubles the risk of adult obesity among both obese and nonobese children under 10 years of age.     

A pilot investigation of a behavioral weight control program with mentally retarded adolescents and adults: Effects on weight, fitness, and knowledge of nutritional and behavioral principles.

Examined the long- and short-term effects of a behavioral weight control program for 10 mentally retarded Ss (mean age 22.7 yrs, mean IQ 52.5) that incorporated teaching about diet, emphasizing exercise, using positive reinforcement, providing periodic weighings, involving parents and group home leaders, and teaching skills to encourage continuing or maintaining weight loss after the end of the program. Weight loss, changes in knowledge of behavioral and nutritional principles, and measures of aerobic fitness and body size were assessed using a nutrition and self-management test. Results indicate significant changes on all measures but arm girth for all Ss at the end of the program, but weight losses were no longer significant at 1-yr follow-up. Ss who were withdrawn from the program by their group home managers showed significant weight gains over the year. Ss' IQ scores were significantly correlated with posttest and follow-up weight losses, and those residing with parents rather than in group homes tended to remain in the program and to lose weight. (8 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Children's concepts of volume and flotation.

Conducted a pilot study in which children (aged 7–9 yrs and 11–13 yrs) were asked to judge which 1 out of 3 wooden blocks would float (or sink), given weight and volume information for each block relative to a block that was known to float (or sink). Analysis of explanations indicated that judgments may have been based on the size–weight illusion. An experiment exploring the basis of flotation judgments was conducted with 14 children aged 7 yrs 1 mo to 9 yrs 6 mo and 16 children aged 11 yrs 4 mo to 14 yrs 11 mo that involved a test for judgment of volume based on information integration theory. Results show that Ss aged 7–24 yrs accurately judged volume by integrating 3 dimensions—width, depth, and height—according to the multiplicative rule. A rule assessment of their flotation judgments showed no age differences in initial rule, with weight rules being most popular. However, after feedback there were marked age effects; the 7–9 yr olds abandoned their initial rule without finding an alternative, and the 11–24 yr olds were generally able to find the correct flotation rule. It is concluded that children aged 7–24 yrs can judge volume but 7–9 yr olds have difficulty with the concept of flotation, possibly because it requires mental comparison of 2 ratios, a task known to be difficult for 7–9 yr olds. (16 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Personality and behavior differences of obese and nonobese adolescents.

36 adolescents categorized as nonobese, obese in a weight control program, and obese who rejected a weight control program were given opportunities to snack and were administered 3 personality tests (Tasks of Emotional Development by Cohen and Weil, the Mooney Problem Check List, and Rotter's Internal-External Control Scale). Results indicate that more obese not in a weight control program ate in an individual eating situation in which they suspected they were being observed. More nonobese ate in a group eating situation in which they did not suspect they were being observed. Results also indicate the highest level of maturity for nonobese adolescents and the lowest level for obese adolescents not in a weight program. Obese adolescents in a weight control program reported fewer "very troublesome" problems than obese adolescents not in a weight control program or nonobese adolescents. (17 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effectiveness of filial therapy for Korean parents.

Explored the effectiveness of filial therapy in enhancing the parent–child relationship of Korean parents (aged 30–42 yrs) of kindergartners (aged 4–8 yrs). The experimental design of the study was a pretest–posttest, control group design in which all of the parents (32 Ss) completed 3 instruments, the Porter Parental Acceptance Scale, the Parenting Stress Index, and the Filial Problem Checklist. The parents were also videotaped playing with their child before and after the training as a means of measuring empathic behavior in parent–child interactions. Results of quantitative and qualitative analyses indicate that Korean parents can learn basic skills of play therapy and improve the relationship with their children. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Filial therapy with single parents: Effects on parental acceptance, empathy, and stress.

Determined the effectiveness of 10-wk filial therapy with parent–child play sessions as a method of prevention and intervention for single parents and their children. The experimental group was comprised of 20 mothers and 2 fathers. There were 19 mothers and 2 fathers in the control group. Parents ranged in age from 19 to 47 yrs. There were 10 girls and 12 boys in the experimental group and 9 girls and 12 boys in the control group. The children in both groups ranged in ages from 3 to 7 yrs. Results of the analysis of covariance (ANCOVA) revealed that single parents in the experimental group significantly increased both their attitude of acceptance and their empathic behavior toward their children, significantly reduced their level of stress related to parenting, and reported significantly fewer problems with their children's behavior. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

American parenting of language-learning children: Persisting differences in family-child interactions observed in natural home environments.

40 families were selected to represent the range of typical American families in size, race, and SES. In data from 2? yrs of once-monthly, hour-long observations of unstructured parent–child interactions in the home, parenting was examined over 27 mo, including the time before, during, and after all the children learned to talk. 10 parent measures suggested by the literature all showed stability in expression within families across time but large differences among the 40 families. The 10 parenting variables clustered into 3 factors relating to (1) the absolute amount of parenting per hour, (2) parents' social interaction with their children, and (3) the contentative quality of the utterances parents addressed to their children. The amount of parenting per hour and the quality of the verbal content associated with that parenting were strongly related to the social and economic status of the family and the subsequent IQ of the child. (PsycINFO Database Record (c) 2010 APA, all rights reserved)