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a Department of Primary Care and General Practice, Medical School, University of Birmingham, Birmingham, United Kingdom
b Centre for Sport and Exercise Science, Sheffield Hallam University, Sheffield, United Kingdom
c Sheffield Children's National Health Service Trust, Sheffield, United Kingdom
d Academic Unit of Child Health, Children's Hospital, Sheffield, United Kingdom
OBJECTIVE. We conducted a proof-of-concept, randomized, controlled trial to investigate the effects of a supervised exercise therapy intervention on psychopathologic outcomes in obese adolescents.
METHODS. The participant sample consisted of 81 adolescents (age: 11–16 years) who had been referred to a children's hospital for evaluation of obesity or who responded to a community advertisement. Participants were assigned randomly to exercise therapy, an equal-contact exercise placebo intervention, or usual care. Intervention participants attended 3 one-on-one sessions per week for 8 weeks and then completed a home program for another 6 weeks. Outcomes included self-perceptions (self-esteem), depression, affect, physical activity, aerobic fitness, and BMI.
RESULTS. A total of 18 of 81 participants were categorized as morbidly obese (BMI SD score: >3.5; adult equivalent BMI:
40). At baseline, 30.3% of participants had a Children's Depression Inventory score of
13, and 27% reported recent suicidal ideation. Repeated-measures mixed analysis of covariance (controlling for baseline scores) revealed significant changes in physical self-worth, associated measures of self-esteem, and physical activity over time, consistently favoring exercise therapy. There were no significant changes in BMI.
CONCLUSIONS. Findings confirmed psychopathologic conditions as a serious health concern in obese and morbidly obese adolescents. Our study is the first randomized, controlled trial to demonstrate that a brief supervised exercise therapy intervention has the potential to improve psychopathologic outcomes significantly and to increase physical activity in obese adolescents, relative to usual care.
Key Words: obesity exercise children psychopathologic conditions weight self-esteem
Abbreviations: HR—heart rate PSW—physical self-worth GSW—global self-worth CDI—Children's Depression Inventory RCT—randomized, controlled trial
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