Cognitive behavioral therapy improves diet and body composition in overweight and obese adolescents

BACKGROUND: Cognitive behavioral therapy (CBT) teaches behavioral and cognitive strategies that focus on achieving and maintaining lifestyle changes. OBJECTIVE: We examined the effectiveness of a CBT program (CHOOSE HEALTH) for improving body composition, diet, and physical activity in overweight and obese adolescents. DESIGN: Adolescents 16 male, 31 female; aged 14.5 +/- 1.6 y; body mass index (BMI; in kg/m(2)) 30.9 +/- 4.2] were block-matched into 2 groups by age, sex, Tanner stage, BMI, and hip and waist circumferences and were randomly assigned to CBT or no treatment (control). CBT consisted of 10 weekly sessions, followed by 5 fortnightly telephone sessions. RESULTS: Compared with the control, over 20 wk, CBT improved (significant group x time interactions) BMI (CBT, -1.3 +/- 0.4; control, 0.3 +/- 0.3; P = 0.007), weight (CBT, -1.9 +/- 1.0 kg; control, 3.8 +/- 0.9 kg; P = 0.001), body fat (CBT, -1.5 +/- 0.9 kg; control, 2.3 +/- 1.0 kg; P = 0.001), and abdominal fat (CBT, -124.0 +/- 46.9 g; control, 50.1 +/- 53.5 g; P = 0.008). CBT showed a greater reduction in intake of sugared soft drinks as a percentage of total energy (CBT, -4.0 +/- 0.9%; control, -0.3 +/- 0.9%; P = 0.005 for group x time interaction), which was related to reductions in weight (r = 0.48, P = 0.04), BMI (r = 0.53, P = 0.02), and waist circumference (r = 0.54, P = 0.02). Physical activity did not change significantly. CONCLUSIONS: A 10-wk CBT program followed by 10 wk of fortnightly phone contact improved body composition in overweight and obese adolescents. Changes in soft drink consumption may have contributed to this benefit.