TY - JOUR
T1 - Improving Treatment Outcome in Children With Obesity by an Online Self-Control Training
T2 - A Randomized Controlled Trial
AU - Vermeiren, Eline
AU - Naets, Tiffany
AU - van Eyck, Annelies
AU - Vervoort, Leentje
AU - Ysebaert, Marijke
AU - Baeck, Nele
AU - de Guchtenaere, Ann
AU - van Helvoirt, Maria
AU - Tanghe, Ann
AU - Bruyndonckx, Luc
AU - de Winter, Benedicte Y.
AU - Verhulst, Stijn L.
AU - van Hoorenbeeck, Kim
AU - Braet, Caroline
N1 - Funding Information: We thank all the children and their parents for participating. Furthermore, we thank the staff of the Zeepreventorium and Mrs. Wendy Degroote from the Jan Palfijn Ghent Hospital for their aid in data collection and organizing the follow-up. Publisher Copyright: Copyright © 2021 Vermeiren, Naets, Van Eyck, Vervoort, Ysebaert, Baeck, De Guchtenaere, Van Helvoirt, Tanghe, Bruyndonckx, De Winter, Verhulst, Van Hoorenbeeck and Braet.
PY - 2021/12/23
Y1 - 2021/12/23
N2 - Background: Currently available treatment programs for children with obesity only have modest long-term results, which is (at least partially) due to the poorer self-control observed within this population. The present trial aimed to determine whether an online self-control training, training inhibition, and redirecting attentional bias, can improve the short- and long-term treatment outcome of (in- or outpatient) child obesity treatment programs. Methods: In this double-blind multi-center randomized controlled trial (RCT), participants aged 8–18 years with obesity were allocated in a 1:1 ratio to receive an online self-control or sham training added to their in- or outpatient multidisciplinary obesity treatment (MOT) program. The primary endpoint was BMI SDS. Data were analyzed by linear mixed models and the main interactions of interest were randomization by time and randomization by number of sessions, as the latter was cumulatively expressed and therefore represents the effect of increasing dose over time. Results: One hundred forty-four inpatient (mean age 14.3 ± 2.2 years, BMI 2.7 ± 0.4 SDS, 42% male) and 115 outpatient children (mean age 11.9 ± 2.1 years, BMI 2.4 ± 0.4 SDS, 45% male) were included. Children's BMI lowered significantly during treatment in both the in- and outpatient treatment centers, p < 0.001. In a mixed model with BMI as dependent variable, randomization by time was non-significant, but the number of self-control trainings (randomization * number of sessions) interacted significantly with setting and with age (p = 0.002 and p = 0.047), indicating a potential effect in younger inpatient residents. Indeed, a subgroup analysis on 22 inpatient children of 8–12 years found a benefit of the number of self-control trainings on BMI (p = 0.026). Conclusions: The present trial found no benefit of the self-control training in the entire study population, however a subgroup of young, inpatient participants potentially benefited.
AB - Background: Currently available treatment programs for children with obesity only have modest long-term results, which is (at least partially) due to the poorer self-control observed within this population. The present trial aimed to determine whether an online self-control training, training inhibition, and redirecting attentional bias, can improve the short- and long-term treatment outcome of (in- or outpatient) child obesity treatment programs. Methods: In this double-blind multi-center randomized controlled trial (RCT), participants aged 8–18 years with obesity were allocated in a 1:1 ratio to receive an online self-control or sham training added to their in- or outpatient multidisciplinary obesity treatment (MOT) program. The primary endpoint was BMI SDS. Data were analyzed by linear mixed models and the main interactions of interest were randomization by time and randomization by number of sessions, as the latter was cumulatively expressed and therefore represents the effect of increasing dose over time. Results: One hundred forty-four inpatient (mean age 14.3 ± 2.2 years, BMI 2.7 ± 0.4 SDS, 42% male) and 115 outpatient children (mean age 11.9 ± 2.1 years, BMI 2.4 ± 0.4 SDS, 45% male) were included. Children's BMI lowered significantly during treatment in both the in- and outpatient treatment centers, p < 0.001. In a mixed model with BMI as dependent variable, randomization by time was non-significant, but the number of self-control trainings (randomization * number of sessions) interacted significantly with setting and with age (p = 0.002 and p = 0.047), indicating a potential effect in younger inpatient residents. Indeed, a subgroup analysis on 22 inpatient children of 8–12 years found a benefit of the number of self-control trainings on BMI (p = 0.026). Conclusions: The present trial found no benefit of the self-control training in the entire study population, however a subgroup of young, inpatient participants potentially benefited.
KW - BMI reduction
KW - attention
KW - childhood obesity
KW - executive functions
KW - inhibition
KW - randomized controlled (clinical) trial
KW - self-control
KW - treatment outcome
UR - http://www.scopus.com/inward/record.url?scp=85122408843&partnerID=8YFLogxK
U2 - https://doi.org/10.3389/fped.2021.794256
DO - https://doi.org/10.3389/fped.2021.794256
M3 - Article
C2 - 35004547
SN - 2296-2360
VL - 9
JO - Frontiers in pediatrics
JF - Frontiers in pediatrics
M1 - 794256
ER -