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Open Access Highly Accessed Research

Effect of a prescriptive dietary intervention on psychological dimensions of eating behavior in obese adolescents

Mandy Ho12, Megan Gow12, Jocelyn Halim2, Kerryn Chisholm4, Louise A Baur13, Manny Noakes5, Katherine Steinbeck6, Michael R Kohn7, Chris T Cowell123 and Sarah P Garnett123*

Author Affiliations

1 The Children’s Hospital at Westmead Clinical School, University of Sydney, Locked Bag 4001, Westmead, NSW 2145, Australia

2 Institute of Endocrinology and Diabetes, The Children’s Hospital at Westmead, Locked Bag 4001, Westmead, NSW 2145, Australia

3 Kids Research Institute, The Children’s Hospital at Westmead, Locked Bag 4001, Westmead, NSW 2145, Australia

4 Nutrition and Dietetics and Weight Management Services, The Children’s Hospital at Westmead, Locked Bag 4001, Westmead, NSW 2145, Australia

5 CSIRO Food and Nutritional Sciences, PO Box 10041, Adelaide BC, SA 5000, Australia

6 Academic Department of Adolescent Medicine, Sydney Medical School, University of Sydney, Sydney, NSW 2066, Australia

7 Centre for Research into Adolescent’s Health, The Children’s Hospital at Westmead, Locked Bag 4001, Westmead, NSW 2145, Australia

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International Journal of Behavioral Nutrition and Physical Activity 2013, 10:119  doi:10.1186/1479-5868-10-119

Published: 24 October 2013

Abstract

Background

Overweight adolescents are more likely to have dysfunctional eating behaviours compared to normal weight adolescents. Little is known about the effects of obesity treatment on the psychological dimensions of eating behavior in this population.

Objective

To examine the effects of a prescriptive dietary intervention on external eating (eating in response to food cues, regardless of hunger and satiety), emotional eating and dietary restraint and their relation to weight loss. Parental acceptability was also examined.

Method

This is a secondary study of a 12-month randomized trial, the RESIST study, which examined the effects of two diets on insulin sensitivity. Participants were 109 obese 10- to 17-year-olds with clinical features of insulin resistance. The program commenced with a 3-month dietary intervention using a structured meal plan, with the addition of an exercise intervention in the next 3 months and followed by a 6 month maintenance period.This paper presents changes in eating behaviors measured by the Eating Pattern Inventory for Children and parent rated diet acceptability during the first 6 months of the trial. As there was no difference between the diets on outcome of interest, both diet groups were combined for analyses.

Results

After 6 months, the proportion of participants who reported consuming more in response to external eating cues decreased from 17% to 5% (P = 0.003), whereas non- emotional eating increased from 48% to 65% (p = 0.014). Dietary restraint and parental pressure to eat remained unchanged. A reduction in external eating (rho = 0.36, P < 0.001) and a reduction in dietary restraint (r = 0.26, P = 0.013) were associated with greater weight loss at 3 and 6 months, respectively. Overall this approach was well accepted by parents with 72% of parents considered that their child would be able to follow the meal plan for the longer term.

Conclusions

In the short to medium term, a prescriptive dietary intervention approach is a well-accepted and suitable option for obese adolescents with clinical features of insulin resistance. It may reduce external and emotional eating, led to modest weight loss and did not cause any adverse effect on dietary restraint.

Trial registration

Australian New Zealand Clinical Trial Registration Number (ACTRN) 12608000416392 https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=83071 webcite

Keywords:
Eating behavior; Structured meal plan; Dietary intervention; Obesity; Adolescent