Associations of Parental Eating Attitudes and Feeding Practices with Attendance and Weight Outcomes in a Family-Based Pediatric Weight Loss Clinic Público

Abstract

Childhood obesity is associated with a multitude of negative mental and physical health outcomes. The preferred treatments are family-based pediatric weight loss programs that include a high degree of parental involvement. However, these programs have variable outcomes and suffer from high rates of attrition. The aims of this study were to 1) describe weight outcomes for a sample of families completing a family-based weight loss program in Atlanta, GA, and 2) to examine parental factors (i.e., parental eating styles and feeding practices) associated with patterns of attendance and weight outcomes in a primarily African American sample of treatment-seeking, obese children and adolescents. Parent/child dyads (N=98) were recruited from a six-month, family-based, weight loss program in an Atlanta pediatric hospital. Child weight outcomes and attendance were tracked via electronic medical records. Parent eating styles were assessed with the Dutch Eating Behavior Questionnaire (i.e., restraint, emotional eating, external eating) and feeding practices with the Child Feeding Questionnaire (i.e., monitoring, restriction). Program attrition was moderate, at 32.7%. Intent-to-treat analyses revealed that children had modest (but insignificant) decreases in BMIz (p>.05), yet significant increases in BMI (p<.01). Families who extended treatment beyond the suggested visit number had poorer weight outcomes than those who dropped out of treatment early or remained in treatment for the recommended duration (p<.001). Parental eating attitudes, child feeding practices, and demographic factors were not associated with attendance patterns (ps >.05). Multiple linear regression analyses indicated that parental external eating was significantly associated with BMI and BMIz increases (β=0.23, p=.02; β=0.24, p=.034) throughout treatment and parental restrained eating was associated with decreases in BMI (β=-0.23, p=0.02). Implications for family-based pediatric weight loss treatment and the differential findings based on weight outcome measures (BMI and BMIz) are discussed. 

Table of Contents

Introduction .............................................................................................................1

Recommended Treatment Interventions.....................................................................2

Variables Associated with FBT Treatment and Outcome................................................3

Present Study.........................................................................................................7

Methods...................................................................................................................9

Participants............................................................................................................9

FBT Program Structure.............................................................................................9

Study Procedure.....................................................................................................11

Measures...............................................................................................................12

Statistical Analyses..................................................................................................16

Results......................................................................................................................18

Demographics and Baseline Weight Characteristics.......................................................18

Parental Profiles of Eating Styles and Feeding Practices.................................................18

Parental Factors Associated with Weight Outcome.........................................................20

Sensitivity Analyses..................................................................................................22

Discussion..................................................................................................................22

Weight Outcomes and Attendance..............................................................................23

Parental Factors and Weight Outcomes........................................................................26

Strengths and Limitations..........................................................................................29

Implications for Treatment and Future Research............................................................31

Conclusions..............................................................................................................32

References..................................................................................................................33

Tables and Figures.......................................................................................................45

Table 1 Sample Characteristics....................................................................................45

Table 2 Descriptive Data for Parent Eating Style............................................................47

Table 3 Attendance Patterns.......................................................................................48

Figure 1 Frequency Distribution of Total Visits Attended..................................................49

Table 4 Wilcoxon-Signed Rank Test Assessing Treatment Outcome...................................50

Table 5 Attendance Group Differences..........................................................................51

Figure 2 Comparing Attendance Groups.......................................................................53

Figure 3 Mean BMI Visit 1 and Final Visit Across Groups.................................................55

Figure 4 Mean BMI Z-Score Visit 1 and Final Visit Across Groups.....................................56

Figure 5 Mean BMI Visits 1 through 3 Across Groups......................................................57

Figure 6 Mean BMI Z-Score Visits 1 through 3 Across Groups..........................................58

Table 7 Multivariate Hierarchical Regression Parental Factors and Change in BMI Z-Score....59

 

Table 8 Multivariate Hierarchical Regression Parental Factors and Change in BMI................60

About this Master's Thesis

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School	Laney Graduate School
Department	Psychology
Subfield / Discipline	Clinical Psychology
Degree	M.A.
Submission	Master's Thesis
Language	English
Research Field	Psychology, Clinical
Palavra-chave	Childhood Obesity Weight Management Parent Modeling Child Feeding Practices Family-Based Weight Loss Eating Styles Weight Loss Intervention
Committee Chair / Thesis Advisor	Craighead, Linda, Emory University
Committee Members	Rodman, Hillary, Emory University Emory, Eugene, Emory University

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