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Updated: Aug 11, 2025
Multidisciplinary Approach to Obesity Management: A Case Report
Published on: May 30, 2025
Exploring predictors and moderators of response to multimodal obesity treatment in children
Simone Aman-Braaksma1, Helen Croker2, Russell M Viner2
1Department of Brain Sciences, Imperial College London, London, UK.
Insights
Childhood obesity interventions show varied effects based on psychological factors. High social functioning in children predicted better BMI reduction with treatment, while poor social functioning showed no treatment effect.
Area of Science:
- Pediatric Endocrinology
- Behavioral Psychology
- Public Health
Background:
- Childhood severe obesity is a significant health concern requiring effective interventions.
- Understanding psychological factors influencing treatment outcomes is crucial for optimizing care.
Purpose of the Study:
- To investigate if specific psychological factors moderate the effectiveness of interventions for severe childhood obesity.
- To identify predictors of treatment success in a clinical setting.
Main Methods:
- Secondary analysis of data from 72 children with severe obesity randomized to family-based behavioral treatment or a waiting list control.
- Regression analyses were used to explore baseline factors and moderators of outcome, including attention deficit/hyperactivity disorder (ADHD) characteristics, body satisfaction, and social-emotional functioning.
Main Results:
- High parental-reported child emotional well-being and high maternal education predicted less weight loss.
- Children's social functioning significantly moderated treatment effects: those with high social function improved with treatment, while those with poor social function showed no difference between treatment and control groups.
- No significant moderation was found for body satisfaction, emotional status, depression, or ADHD.
Conclusions:
- Preliminary findings suggest psychological factors, particularly social functioning, are important in tailoring childhood obesity interventions.
- Healthcare professionals should consider a child's social and emotional status when designing or selecting obesity treatment programs.
- The risks associated with non-intervention warrant careful consideration.
Objective:
The aim of this study was to determine whether specific psychological factors influence intervention effects for children with severe obesity in a clinical setting.
Design:
Secondary analyses of data about attention deficit/hyperactivity disorder (ADHD) characteristics, body satisfaction, social and emotional functioning, and the primary outcome, change in body mass index (BMI), were available for 41 out of 72 children and their families randomised to family-based behavioural treatment over 6 months or waiting list control. Regression analyses, with an interaction term for treatment condition, were performed to explore baseline factors and moderators of outcome.
Results:
Parents reporting their child's emotional well-being as high and high maternal education significantly predicted less weight loss for the total sample, with no effect of ethnicity, age, sex or baseline BMI. Children's social functioning was a significant moderator of treatment effect; children with high social function showed a decrease in BMI after 6 months of therapy (R2=0.08-0.13), whereas an increase in BMI was observed in children with high social function who waited for treatment. For children with poor social function, no treatment effect was observed-subjects lost weight in both conditions. No significant moderation effect was found for body (dis)satisfaction, emotional status, comorbid depression or ADHD, adjusting for baseline BMI, age, sex and ethnicity.
Conclusions:
These preliminary findings suggest directions for development of tailored obesity programmes. Professionals engaged in treatment of childhood obesity should consider a child's emotional and social functioning when considering group obesity intervention, as well as the risks of no intervention.
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