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Exploring predictors and moderators of response to multimodal obesity treatment in children
  1. Simone Aman-Braaksma1,
  2. Helen Croker2,
  3. Russell M Viner2,
  4. Dasha Nicholls1
  1. 1 Department of Brain Sciences, Imperial College London, London, UK
  2. 2 Population, Policy and Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health Population Policy and Practice, London, UK
  1. Correspondence to Dr Dasha Nicholls, Department of Brain Sciences, Imperial College London, Harpenden SW7 2BX, UK; d.nicholls{at}


Objective The aim of this study was to determine whether specific psychological factors influence intervention effects for children with severe obesity in a clinical setting.

Design Secondary analyses of data about attention deficit/hyperactivity disorder (ADHD) characteristics, body satisfaction, social and emotional functioning, and the primary outcome, change in body mass index (BMI), were available for 41 out of 72 children and their families randomised to family-based behavioural treatment over 6 months or waiting list control. Regression analyses, with an interaction term for treatment condition, were performed to explore baseline factors and moderators of outcome.

Results Parents reporting their child’s emotional well-being as high and high maternal education significantly predicted less weight loss for the total sample, with no effect of ethnicity, age, sex or baseline BMI. Children’s social functioning was a significant moderator of treatment effect; children with high social function showed a decrease in BMI after 6 months of therapy (R2=0.08–0.13), whereas an increase in BMI was observed in children with high social function who waited for treatment. For children with poor social function, no treatment effect was observed—subjects lost weight in both conditions. No significant moderation effect was found for body (dis)satisfaction, emotional status, comorbid depression or ADHD, adjusting for baseline BMI, age, sex and ethnicity.

Conclusions These preliminary findings suggest directions for development of tailored obesity programmes. Professionals engaged in treatment of childhood obesity should consider a child’s emotional and social functioning when considering group obesity intervention, as well as the risks of no intervention.

  • obesity
  • mental health
  • psychology

Data availability statement

Data are available upon reasonable request.

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Data availability statement

Data are available upon reasonable request.

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  • Contributors DN conceived the study idea. DN and SA-B designed the study. SA-B (with HC) performed the analysis and drafted the paper. All authors reviewed the analysis and final paper. DN accepts responsibility for the work and acts as guarantor

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; internally peer reviewed.