Skip to main content
Search
Search
    Quick Search anywhere
    Quick search in Citations
Advanced Search
Skip main navigationClose Drawer MenuOpen Drawer Menu
Next article
Originalia

Adipositastherapie bei Kindern und Jugendlichen:

Eine Metaanalyse zur Effektivität von Verhaltenstherapie

Published Online:September 01, 2006https://doi.org/10.1026/0943-8149.12.3.89

Abstract

Zusammenfassung. Dargestellt wird eine Metaanalyse zum Thema “Wirksamkeit verhaltenstherapeutischer Adipositastherapie bei Kindern und Jugendlichen“. Nach einer zusammenfassenden Beschreibung der Charakteristika von 35 Studien werden die Ergebnisse von 17 untersuchten Therapiegruppen, für die Effektstärken berechnet werden konnten, deskriptivstatistischen Effektstärkenanalysen unterzogen. Auf der Basis der Daten von 352 untersuchten Personen ergab sich eine Effektstärke von d = 1.85 für den Body Mass Index (BMI) bzw. von 2.12 für das prozentuale Übergewicht (N = 131) im Prä-post-Vergleich. Zum Katamnesezeitpunkt lagen die Effektstärken bei 0.56 für den BMI (N = 120) bzw. 0.77 für das prozentuale Übergewicht (N = 88). Bezüglich des Selbstwerts ergaben sich Effektstärken von 0.52 (N = 96) nach der Therapie bzw. 0.65 zur Katamnese (N = 75). Abschließend werden die Aussagekraft der Ergebnisse dieser Metaanalyse kritisch diskutiert und Vorschläge für die zukünftige Forschung zum genannten Thema formuliert.


Adiposity therapy with children and adolescents: A meta-analysis of the effectiveness of behavior therapy

Abstract. A meta-analysis on the effectiveness of behavior therapy in obese children and adolescents is presented. After the description of the main characteristics of 35 studies, the results of 17 treatment groups, for which effect sizes could be calculated, are summarized statistically. Based on the data of 352 treated children the effect size was d = 1.85 for the body mass index (BMI) and 2.12 for percent overweight (N = 131) in the pre-post comparison. At follow-up, the effect sizes were 0.56 for the BMI (N = 120) and 0.77 for percent overweight (N = 80). For the psychological variable “self-worth” the effect sizes were 0.52 (N = 96) and 0.65 (N = 75), respectively. The results of this meta-analysis are critically discussed and implications for research in this area are suggested.

Literatur

  • Allison, D. B. , Faith, M. S. , Gorman, B. S. (1996). Publication bias in obesity treatment trials?. International Journal of Obesity and Related Metabolic Disorders , 20 , 931– 937 . First citation in articleGoogle Scholar

  • Barlow, S. E. , Dietz, W. H. (1998). Obesity evaluation and treatment: Expert Committee recommendations. The Maternal and Child Health Bureau, Health Resources and Services Administration and the Department of Health and Human Services. Pediatrics , 102 , 3 . First citation in articleCrossref, Google Scholar

  • Becker, E. S. , Margraf, J. , Türke, V. , Soeder, U. , Neumer, S. (2001). Obesity and mental illness in a representative sample of young women. International Journal of Obesity , 25 , 5– 9 . First citation in articleCrossref, Google Scholar

  • Beelmann, A. , Bliesener, T. (1994). Aktuelle Probleme und Strategien der Metaanalyse. Psychologische Rundschau , 45 , 211– 233 . First citation in articleGoogle Scholar

  • Benecke, A. (2002). Verhaltenstherapie bei Adipositas. Verhaltenstherapie , 12 , 297– 309 . First citation in articleCrossref, Google Scholar

  • Cohen, J. (1977). Statistical power analysis for the behavioral sciences . New York: Academic Press . First citation in articleGoogle Scholar

  • Cole, T. , Bellizzi, M. , Flegal, K. , Dietz, W. H. (2000). Establishing a standard definition for child overweight and obesity worldwide: International survey. British Medical Journal , 320 , 1240– 1243 . First citation in articleCrossref, Google Scholar

  • Deutsche Adipositasgesellschaft (2001). Leitlinien der Deutschen Adipositasgesellschaft. Adipositas im Kindes- und Jugendalter . Verfügbar unter: http://www.uni-duesseldorf.de/WWW/AWMF/ll/adip-002.htm [Februar 2001] . First citation in articleGoogle Scholar

  • Dietz, W. H. (1995). Childhood obesity: Prevalence and effects. In K. D. Brownell & C. G. Fairburn (Eds.), Eating disorders. A comprehensive handbook (pp.438-440). New York: The Guilford Press . First citation in articleGoogle Scholar

  • Dietz, W. H. (1998). Childhood weight affects adult morbidity and mortality. The Journal of Nutrition , 128 , 411– 414 . First citation in articleCrossref, Google Scholar

  • Dietz, W. H. (2001). The obesity epidemic in young children: Reduce television viewing and promote playing. British Medical Journal , 322 , 313– 314 . First citation in articleCrossref, Google Scholar

  • French, S. A. , Perry, C. L. , Leon, G. R. , Fulkerson, J. A. (1996). Self-esteem and change in body mass index over 3 years in a cohort of adolescents. Obesity research , 4 , 27– 33 . First citation in articleCrossref, Google Scholar

  • Fromme, K. (2001). Adipositas im Kindes- und Jugendalter: kurz- und längerfristige Wirkungen der Behandlung im stationären Rahmen . Norderstedt: Books on Demand . First citation in articleGoogle Scholar

  • Gibbons, R. D. , Hedeker, D. R. , Davis, J. M. (1993). Estimation of effect size from a series of experiments involving paired comparisons. Journal of Educational Statistics , 18 , 271– 279 . First citation in articleCrossref, Google Scholar

  • Goldfield, G. S. , Raynor, H. A. , Epstein, L. H. (2002). Treatment of pediatric obesity. In T. A. Wadden & A. J. Stunkard (Eds.), Handbook of obesity treatment (pp. 532-555). New York: Guilford Press . First citation in articleGoogle Scholar

  • Haddock, C. K. , Dill, P. L. , Poston, W. S. C. , Foreyt, J. P. , Hymen, D. , Stein, R. J. (1998). Pharmacotherapy for obesity: A meta-analysis of controlled trials. Coding manual . Unpublished manuscript, University of Missouri, Kansas City, Department of Psychology . First citation in articleGoogle Scholar

  • Haddock, C. K. , Shadish, W. R. , Klesges, R. C. , Stein, R. J. (1994). Treatments for childhood and adolescent obesity. Annals of Behavioral Medicine , 16 , 235– 244 . First citation in articleGoogle Scholar

  • Hartung, J. , Knapp, G. (2003). An alternative test procedure for meta-analysis. In R. Schultze, H. Holling & D. Böhning (Eds.), Meta-analysis. New developments and applications in medical and social sciences (pp. 53-69). Ashland, OH, US: Hogrefe & Huber Publishers . First citation in articleGoogle Scholar

  • Hedges, L. V. (1981). Distribution theory for Glass’s estimator of effect size and related estimators. Journal of Educational Statistics , 6 , 107– 128 . First citation in articleCrossref, Google Scholar

  • Hedges, L. V. (1983). A random effects model for effect sizes. Psychological Bulletin , 93 , 388– 395 . First citation in articleCrossref, Google Scholar

  • Jelalian, E. , Saelens, B. E. (1999). Empirically supported treatments in pediatric psychology: pediatric obesity. Journal of Pediatric Psychology , 24 , 223– 248 . First citation in articleCrossref, Google Scholar

  • Kertesz, M. , Pollak, Z. , Greiner, E. (1992). Evaluation of self-image of overweight teenagers living in Budapest. Journal of Adolescent Health , 13 , 396– 397 . First citation in articleCrossref, Google Scholar

  • Kromeyer-Hauschild, K. , Wabitsch, M. , Geller, F. , Ziegler, A. , Geiß, H. C. , Hesse, V. , Hippel, V. , Jaeger, U. , Johnsen, D. , Kiess, W. , Korte, W. , Kunze, D. , Menner, K. , Müller, M. , Niemann-Pilatus, A. , Remer, T. , Schaefer, F. , Wittchen, H. U. , Zabransky, S. , Zellner, K. , Hebebrand, J. (2001). Perzentile für den Body Mass Index für das Kindes- und Jugendalter unter Heranziehung verschiedener deutscher Stichproben. Monatsschrift Kinderheilkunde , 149 , 807– 818 . First citation in articleCrossref, Google Scholar

  • Laessle, R. G. , Lehrke, S. , Wurmser, H. , Pirke, K. M. (2001). Adipositas im Kindes- und Jugendalter. Basiswissen und Therapie . Berlin: Springer . First citation in articleGoogle Scholar

  • Lehrke, S. , Laessle, R. G. (2003). Adipositas. In U. Ehlert (Hrsg.), Lehrbuch der Verhaltensmedizin (S. 497-529). Berlin: Springer . First citation in articleCrossref, Google Scholar

  • Manus, H. E. , Killeen, M. R. (1995). Maintenance of self-esteem by obese children. Journal of Child and Adolescent Psychiatric Nursing , 8 , 17– 27 . First citation in articleCrossref, Google Scholar

  • Morris, S. B. , DeShon, R. P. (2002). Combining effect size estimates in meta-analysis with repeated measures and independent-groups designs. Psychological Methods , 7 , 105– 125 . First citation in articleCrossref, Google Scholar

  • Petermann, F. , Grunewald, L. , Gartmann-Skambracks, A. , Warschburger, P. (1999). Verhaltenstherapeutische Behandlung der kindlichen Adipositas. Kindheit und Entwicklung , 8 , 206– 217 . First citation in articleLink, Google Scholar

  • Pierce, R. A. , Wardle, J. (1993). Self-esteem, parental appraisal and body size in children. Journal of Child Psychology and Psychiatry , 34 , 1125– 1136 . First citation in articleCrossref, Google Scholar

  • R Development Core Team (2003). R: A language and environment for statistical computing . Vienna, Austria: R Foundation for Statistical Computing . First citation in articleGoogle Scholar

  • Strauss, R. S. (2000). Childhood obesity and self-esteem. Pediatrics , 105 , 15– . First citation in articleCrossref, Google Scholar

  • Wadden, T. A. , Stunkard, A. J. (1985). Social and psychological consequences of obesity. Annals of Internal Medicine 103 , 1062– 1067 . First citation in articleGoogle Scholar

  • Warschburger, P. , Petermann, F. , Fromme, C. , Wojtalla, N. (1999). Adipositastraining mit Kindern und Jugendlichen . Weinheim: Beltz . First citation in articleGoogle Scholar

  • Wirth, A. (1997). Adipositas. Epidemiologie, Ätiologie, Folgekrankheiten, Therapie . Berlin: Springer . First citation in articleGoogle Scholar

  • Literaturverzeichnis der ausgewerteten Studien 3 . First citation in articleGoogle Scholar

  • Amador, M. , Ramos, L. T. , Morono, M. , Hermelo, M. P. (1990). Growth rate reduction during energy restriction in obese adolescents. Experimental and Clinical Endocrinology , 96 , 73– 82 . First citation in articleCrossref, Google Scholar

  • *Barnow, S. , Bernheim, D. , Schröder, C. , Lauffer, H. , Fusch, C. , Freyberger, H.-J. (2003). Adipositas im Kindes- und Jugendalter. Erste Ergebnisse einer multimodalen Interventionsstudie in Mecklenburg-Vorpommern. Psychotherapie, Psychosomatik, medizinische Psychologie , 53 , 7– 14 . First citation in articleCrossref, Google Scholar

  • Berg, A. , Korsten-Reck, U. (1995). Strategien zur Verbesserung des Aktivitäts- und Ernährungsverhaltens bei Kindern und Jugendlichen. Der Lipidreport , 1 , 15– 22 . First citation in articleGoogle Scholar

  • Berkowitz, R. I. , Wadden, T. , Tershakovec, A. M. , Cronquist, J. L. (2003). Behavior therapy and sibutramine for the treatment of adolescent obesity. A randomized controlled trial. Journal of the American Medical Association , 289 , 1805– 1812 . First citation in articleCrossref, Google Scholar

  • *Brehm, B. J. , Rourke, K. M. , Cassell, C. (1999). Improved psychosocial outcomes of young female participants in an multidisciplinary weight loss program. American Journal of Health Behavior , 99 (suppl. 9) , 122– . First citation in articleGoogle Scholar

  • Brehm, B. J. , Rourke, K. M. , Cassell, C. , Sethuraman, G. (2003). Psychosocial outcomes of a pilot multidisciplinary program for weight management. American Journal of Health Behavior , 27 , 248– 354 . First citation in articleCrossref, Google Scholar

  • Rourke, K. M. , Brehm, B. J. , Cassell, C. , Sethuraman, G. (2003). Effect of weight change on bone mass in femaleadolescents. Journal of the American Dietetic Association , 103 , 369– 372 . First citation in articleCrossref, Google Scholar

  • Chen, W. , Chen, S.-C. , Hsu, H.-S. , Lee, C. (1997). Counseling clinic for pediatric weight reduction: program formulation and follow-up. Journal of the Formosan Medical Association , 96 , 59– 62 . First citation in articleGoogle Scholar

  • Duffy, G. , Spence, S. H. (1993). The effectiveness of cognitive self-management as an adjunct to a behavioural intervention for childhood obesity: A research note. Journal of Child Psychology and Psychiatry , 34 , 1034– 1050 . First citation in articleCrossref, Google Scholar

  • Emes, C. , Velde, B. , Moreau, M. , Morduch, D. D. , Trussell, R. (1990). An activity based weight control program. Adapted Physical Activity Quarterly , 7 , 314– 324 . First citation in articleCrossref, Google Scholar

  • Endo, H. , Takagi, Y. , Nozue, T. , Kuwahata, K. , Uemusa, F. , Kobayashi, A. (1992). Beneficial effects of dietary intervention on serum lipid and apolipoprotein levels in obese children. American Journal of Diseases of Children , 146 , 303– 305 . First citation in articleGoogle Scholar

  • Epstein, L. H. , McKenzie, S. J. , Valoski, A. M. , Klein, K. R. , Wing, R. R. (1994). Effects of mastery criteria and contingent reinforcement for family-based child weight control. Addictive Behaviors , 19 , 135– 145 . First citation in articleCrossref, Google Scholar

  • *Epstein, L. H. , Paluch, R. A. , Gordy, C. C. , Dorn, J. (2000a). Decreasing sedentary behaviors in treating pediatric obesity. Archives of Pediatrics and Adolescent Medicine , 154 , 220– 226 . First citation in articleCrossref, Google Scholar

  • Epstein, L. H. , Paluch, R. A. , Gordy, C. C. , Saelens, B. E. , Ernst, M. M. (2000b). Problem solving in the treatment of childhood obesity. Journal of Consulting and Clinical Psychology , 68 , 717– 721 . First citation in articleCrossref, Google Scholar

  • Epstein, L. H. , Valoski, A. M. , Vara, L. S. , McCurley, J. , Wisniewski, L. , Kalarchian, M. A. , Klein, K. R. , Shrager, L. R. (1995). Effects of decreasing sedentary behavior and increasing activity on weight change in obese children. Health Psychology , 14 , 109– 115 . First citation in articleCrossref, Google Scholar

  • *Figueroa-Colon, R. , Almen, T. K. von , Franklin, F. A. , Schuftan, C. , Suskind, R. M. (1993). Comparison of two hypocaloric diets in obese children. American Journal of Diseases of Children , 147 , 160– 166 . First citation in articleGoogle Scholar

  • Fromme, K. (2001). Adipositas im Kindes- und Jugendalter: kurz- und längerfristige Wirkungen der Behandlung im stationären Rahmen . Norderstedt: Books on Demand . First citation in articleGoogle Scholar

  • Israel, A. C. , Guile, C. A. , Baker, J. E. , Silverman, W. K. (1994). An evaluation of enhanced self-regulation training in the treatment of childhood obesity. Journal of Pediatric Psychology , 19 , 737– 749 . First citation in articleCrossref, Google Scholar

  • Israel, A. C. , Solotar, L. C. , Ziman, E. (1990). An investigation of two parental involvement roles in the treatment of obese children. International Journal of Eating Disorders , 9 , 557– 564 . First citation in articleCrossref, Google Scholar

  • Jacob, K. (1998). Determinanten und Modifikation der Adipositas bei Kindern . Hamburg: Verlag Dr. Kovac . First citation in articleGoogle Scholar

  • *Jelalian, E. , Mehlenbeck, R. (2002). Peer-enhanced weight management treatment for overweight adolescents: some preliminary findings. Journal of Clinical Psychology in Medical Settings , 9 , 15– 23 . First citation in articleCrossref, Google Scholar

  • *Johnson, W. G. , Hinkle, L. K. , Carr, R. E. , Anderson, D. A. , Lemmon, C. R. , Engler, L. B. , Bergeron, K. C. (1997). Dietary and exercise interventions for juveline obesity: long-term effect of behavioral and public health models. Obesity research , 5 , 257– 261 . First citation in articleCrossref, Google Scholar

  • Koletzko, B. , Dokoupil, K. , Knoppke, B. , Ellrott, T. , Lichtenstein, S. , Pudel, V. (1999). Adipositas-Therapie in der Kinderarztpraxis. Klinische Pädiatrie , 211 , 100– . First citation in articleGoogle Scholar

  • Knoppke, B. , Holzer, C. , Dokoupil, K. , Ellrott, T. , Lichtenstein, S. , Pudel, V. , Vögele, C. , Koletzko, B. (2000). Evaluation eines neuen ambulanten Therapieprogrammsfür übergewichtige Kinder. Aktuelle Ernährungsmedizin , 25 , 256– . First citation in articleGoogle Scholar

  • Korsten-Reck, U. , Rudloff, C. , Kayser, R. , Eßer, K.-J. , Grupe, M. , Emunds, U. , Kromeyer-Hauschild, K. , Rücker, G. , Wolfarth, B. , Berg, A. (o.J.) Freiburger Interventionsprogramm zur ambulanten Therapie der Adipositas im Kindesalter (FITOC), Multiplikation . Verfügbar unter: www.fitoc.de/artikel.htm [Dezember 2002] . First citation in articleGoogle Scholar

  • Korsten-Reck, U. , Wolfarth, B. , Keul, J. , Berg, A. (1999). Freiburger Interventionsprogramm zur ambulanten Therapie der Adipositas im Kindes- und Jugendalter. Adipositas , 18 , 17– 26 . First citation in articleGoogle Scholar

  • *Lehrke, S. (2003). Adipositastherapie bei übergewichtigen Kindern: Vergleich einer multimodalen verhaltenstherapeutischen Gruppentherapie mit einer inhaltlich identischen Familientherapie mit zusätzlichen systemischen Komponenten . Inauguraldissertation an der Universität Trier . First citation in articleGoogle Scholar

  • Lehrke, S. , Laessle, R. G. (2002). Multimodale Therapiebei übergewichtigen Kindern: Therapieeffekte zu psychosozialen Variablen. Verhaltenstherapie , 12 , 256– 266 . First citation in articleCrossref, Google Scholar

  • Nuutinen, O. (1991). Long-term effects of dietary counselling on nutrient intake and weight loss in obese children. European Journal of Clinical Nutrition , 45 , 287– 297 . First citation in articleGoogle Scholar

  • Petermann, F. , Borzel, B. , Bauer, C. P. (1993). Verhaltenstraining mit adipösen Kindern in der Rehabilitation. Kindheit und Entwicklung , 2 , 107– 117 . First citation in articleGoogle Scholar

  • Rist, G. , Borzel, B. , Petermann, F. , Bauer, C. P. (1995). Das Eßverhaltenstraining bei Adipositas im Kindesalter. Ein neuer Ansatz bei der Langzeitbehandlung übergewichtiger Kinder. Pädiatrische Praxis , 49 , 243– 252 . First citation in articleGoogle Scholar

  • Reinehr, T. , Brylak, K. , Alexy, U. , Kersting, M. , Andler, W. (2003). Predictors to success in outpatient training in obese children and adolescents. International Journal of Obesity , 27 , 1087– 1092 . First citation in articleCrossref, Google Scholar

  • Reinehr, T. , Chahda, C. , Kersting, M. , Andler, W. (2000). Dattelner Schulungsprogramm “Obeldicks“ für adipöseKinder. Aktuelle Ernährungsmedizin , 25 , 258– . First citation in articleGoogle Scholar

  • Reinehr, T. , Kersting, M. , Alexy, U. , Andler, W. (2003). Long-term follow-up of overweight children: after training, after a single consultation session, and without treatment. Journal of Pediatric Gastroenterology and Nutrition , 37 , 72– 74 . First citation in articleCrossref, Google Scholar

  • *Reybrouck, T. , Vinckx, J. , Van Den Berghe, G. , Vanderschueren-Lodeweyckx, M. (1990). Exercise therapy and hypocaloric diet in the treatment of obese children and adolescents. Acta Paediatrica Scandinavica , 79 , 84– 89 . First citation in articleCrossref, Google Scholar

  • Saelens, B. E. , McGrath, A. M. (2003). Self-monitoring adherence and adolescent weight control efficacy. Children’s Health Care , 32 , 137– 152 . First citation in articleCrossref, Google Scholar

  • Saelens, B. E. , Sallis, J. F. , Wilfley, D. E. , Patrick, K. , Cella, J. A. , Bucjta, R. (2002). Behavioral weight control foroverweight adolescents initiated in primary care. Obesity research , 10 , 22– 32 . First citation in articleCrossref, Google Scholar

  • *Siegfried, W. , Siegfried, A. (2000). Langzeittherapie von hochgradiger Adipositas bei Jugendlichen. Kindheit und Entwicklung , 9 , 102– 107 . First citation in articleLink, Google Scholar

  • Slotta-Bachmayr, B. (1997). Ernährungsverhalten und Gewichtskontrolle bei adipösen Kindern und Jugendlichen. Eine interdisziplinäre Studie . Frankfurt am Main: Peter Lang . First citation in articleGoogle Scholar

  • Stauber, T. , Petermann, F. , Haase, A. , Hampel, P. (2001). Kombiniertes Adipositas- und Anti-Stress-Training im ambulanten Bereich - Eine Pilotstudie. Kindheit und Entwicklung , 10 , 240– 247 . First citation in articleLink, Google Scholar

  • Suskind, R. M. , Sothern, M. S. , Farris, R. P. , Almen, T. K. von , Schuhmacher, H. , Carlisle, L. , Vargas, A. , Escobar, O. , Loftin, M. , Fuchs, G. , Brown, R. , Udall, jr., J. N. (1993). Recent advances in the treatment of childhood obesity. Annals of the New York Academy of Sciences , 699 , 181– 191 . First citation in articleCrossref, Google Scholar

  • Tiedjen, U. , Petermann, F. , Sievers, K. , Stachow, R. (2000). Langfristige Effekte der Adipositastherapie in der stationären Rehabilitation von Kindern und Jugendlichen. Kindheit und Entwicklung , 9 , 94– 101 . First citation in articleLink, Google Scholar

  • *Wabitsch, M. , Braun, U. , Heinze, E. , Muche, R. , Mayer, H. , Teller, W. , Fusch, C. (1996). Body composition in 5-18 year-old obese children and adolescents before and after weight reduction as assessed by deuterium dilution and bioelectrical impedance analysis. American Journal of Clinical Nutrition , 64 , 1– 6 . First citation in articleCrossref, Google Scholar

  • Wabitsch, M. , Weyhreter, H. , Kriechbaum, M. (1992). Prävention und Therapie der Adipositas im Kindesalter.Diskussionsbeitrag der Adipositasgruppe an der Universitätskinderklinik Ulm. Adipositas , 4 , 18– 21 . First citation in articleGoogle Scholar

  • Wadden, T. A. , Stunkard, A. J. , Rich, L. , Rubin, C. , Sweidel, G. , McKinney, S. (1990). Obesity in black adolescent girls: a controlled clinical trial of treatment by diet, behavior modification, and parental support. Pediatrics , 85 , 345– 352 . First citation in articleGoogle Scholar

  • Weyhreter, H. , Tannhäuser, S. , Muche, R. , Debatin, M. , Heinze, E. , Strittmatter, U. , Räkel-Rehner, S. , Wabitsch, M. (2003). Ergebnisse einer ambulanten Behandlung von Kindern und Jugendlichen mit Adipositas. Klinische Pädiatrie , 215 , 57– 64 . First citation in articleCrossref, Google Scholar