title: Cognitive behavioral therapy improves diet and body composition in overweight and obese adolescents.
abstract: 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.
  
  
  METHODS
  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.
authors.affiliation: Australian Technology Network Centre for Metabolic Fitness, School of Health Sciences, University of South Australia, Adelaide, Australia.
authors.forename: Margarita D
authors.initials: MD
authors.lastname: Tsiros
authors.forename: Natalie
authors.initials: N
authors.lastname: Sinn
authors.forename: Leah
authors.initials: L
authors.lastname: Brennan
authors.forename: Alison M
authors.initials: AM
authors.lastname: Coates
authors.forename: Jeff W
authors.initials: JW
authors.lastname: Walkley
authors.forename: John
authors.initials: J
authors.lastname: Petkov
authors.forename: Peter R C
authors.initials: PR
authors.lastname: Howe
authors.forename: Jonathan D
authors.initials: JD
authors.lastname: Buckley
mesh_terms: D000293:Adolescent; D017195:Adolescent Nutritional Physiological Phenomena; D001823:Body Composition; D015992:Body Mass Index; D002253:Carbonated Beverages / Q000009:adverse effects; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003131:Combined Modality Therapy; D004032:Diet / Q000523:psychology* / Q000592:standards*; D015444:Exercise / Q000502:physiology / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D009765:Obesity / Q000523:psychology / Q000628:therapy*; D050177:Overweight / Q000523:psychology / Q000628:therapy*; D000297:Psychology, Adolescent; D015431:Weight Loss