General and Eating Disorder Psychopathology in Relation to Short- and Long-Term Weight Change in Treatment-Seeking Children: A Latent Profile Analysis

Author:

Grammer Anne Claire1ORCID,Best John R2,Fowler Lauren A1,Balantekin Katherine N3,Stein Richard I4,Conlon Rachel P Kolko5,Saelens Brian E6,Welch R Robinson1,Perri Michael G7,Epstein Leonard H8,Wilfley Denise E1

Affiliation:

1. Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA

2. Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada

3. Department of Exercise and Nutrition Sciences, School of Public Health and Health Professions, University at Buffalo, Buffalo, NY, USA

4. Department of Internal Medicine, Washington University School of Medicine, St. Louis, MO, USA

5. Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA

6. Department of Pediatrics, University of Washington and Seattle Children’s Research Institute, Seattle, WA, USA

7. Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA

8. Department of Pediatrics, Division of Behavioral Medicine, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, NY, USA

Abstract

Abstract Background Concurrent general psychopathology (GP) and eating disorder psychopathology (EDP) are commonly reported among youth with overweight/obesity and may impact weight change. Purpose We identified patterns of GP and EDP in children with overweight/obesity and examined the impact on weight change following family-based behavioral obesity treatment (FBT) and maintenance interventions. Methods Children (N = 172) participated in 4 month FBT and subsequent 8 month weight maintenance interventions. GP and EDP were assessed prior to FBT (baseline). Child percentage overweight was assessed at baseline, post-FBT (4 months), and post-maintenance (12 months). Latent profile analysis identified patterns of baseline GP and EDP. Linear mixed-effects models examined if profiles predicted 4- and 12-month change in percentage overweight and if there were two-way and three-way interactions among these variables, adjusting for relevant covariates. Results Results indicated a three-profile structure: lower GP and EDP (LOWER); subclinically elevated GP and EDP without loss of control (LOC; HIGHER); and subclinically elevated GP and EDP with LOC (HIGHER + LOC). Across profiles, children on average achieved clinically meaningful weight loss (i.e., ≥9 unit change in percentage overweight) from baseline to 4 month FBT and sustained these improvements at 12 month maintenance. There was no evidence that latent profiles were related to percentage overweight change from baseline to FBT (p > .05) or baseline to maintenance (p > .05). There was no evidence for two-way or three-way interactions (p > .05). Conclusion Concurrent GP and EDP do not portend differential short- or long-term weight change following FBT and maintenance. Future research is warranted on the durability of weight change among youth with GP and EDP. Trial registration NCT00759746.

Funder

Eunice Kenney Shriver

National Institute of Child Health and Human Development

National Heart, Lung, and Blood Institute

Publisher

Oxford University Press (OUP)

Subject

Psychiatry and Mental health,General Psychology

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