Can we treat morbid obese children in a behavioral inpatient program?
Cognitive-Behavioral therapy (CBT) combined with a family -based intervention has proven as the most effective psychological approach for eating disorders in children and adolescents. The aim of the present paper is to present such a program in a population of severe morbid obese pediatric patients in an inpatient setting in our medical psychiatric unit specializing in the treatment of eating disorders. Our CBT program was developed according to the Cooper/Fairburn approach to the treatment of obesity. The program is organized in a series of treatment modules that include: 1. starting treatment: pre-admission phase; 2. establishing and maintaining weight loss; 3. encouraging acceptance, addressing realistic expectations to body weight, and addressing body image concerns; 4. long-term weight maintenance. Family intervention and physical activity were implemented throughout the program. The children enrolled in our program suffer from morbid obesity with life-threatening medical complications such as obstructive sleep apnea, intra-cranial pressure, and debilitating joint disease that required an aggressive, invasive approach. The aim of the program is not only to achieve a rapid weight reduction and avoiding invasive medical procedures, but also to minimize subsequent weight regain. Two patients representing the complexity of conducting the program are presented.
Fennig
Silvana
S
Children and Adolescent Medical Psychiatric Unit, Schneider Children's Medical Center of Israel, Petah Tiqwa and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. silvanaf@clalit.org.it
Fennig
Shmuel
S
D000293:Adolescent; D002648:Child; D002673:Child, Hospitalized; D015928:Cognitive Behavioral Therapy / Q000458:organization & administration*; D005260:Female; D006801:Humans; D007297:Inpatients; D008297:Male; D009767:Obesity, Morbid / Q000523:psychology / Q000628:therapy*; D010372:Pediatrics / Q000458:organization & administration*; D015397:Program Evaluation; D011567:Psychiatric Department, Hospital / Q000458:organization & administration*; D002666:Psychology, Child; D015431:Weight Loss