title: Exercise therapy as a treatment for psychopathologic conditions in obese and morbidly obese adolescents: a randomized, controlled trial.
abstract: 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: > or = 40). At baseline, 30.3% of participants had a Children's Depression Inventory score of > or = 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.
authors.affiliation: Department of Primary Care and General Practice, University of Birmingham, Clinical Sciences Building, Birmingham, B15 2TT, United Kingdom. a.daley@bham.ac.uk
authors.forename: Amanda J
authors.initials: AJ
authors.lastname: Daley
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Copeland
authors.forename: Neil P
authors.initials: NP
authors.lastname: Wright
authors.forename: Andrea
authors.initials: A
authors.lastname: Roalfe
authors.forename: Jerry K H
authors.initials: JK
authors.lastname: Wales
mesh_terms: D000293:Adolescent; D002648:Child; D005081:Exercise Therapy; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000209:etiology / Q000628:therapy; D009765:Obesity / Q000150:complications / Q000523:psychology* / Q000628:therapy*; D009767:Obesity, Morbid / Q000150:complications / Q000523:psychology / Q000628:therapy