Psychological Predictors of Family-Based Behavioral Treatment Response in a Diverse Sample of Youth With Obesity

Objective: Despite strong evidence supporting the efficacy of family-based behavioral treatment (FBBT) for pediatric obesity, programs rarely achieve optimal effectiveness for all youth. Understanding treatment response among racially/ethnically diverse youth and the role of psychological concerns in obesity treatment response will better inform pediatric psychologists' treatment recommendations in pediatric obesity populations. The current study aimed to evaluate (a) FBBT effectiveness in a racially/ethnically diverse population and (b) the rates, and possible impact, of psychological comorbidities at baseline on treatment outcomes. Method: Participants included 351 youth who had obesity and their families who participated in 12 weeks of group FBBT. Parent-reported psychological concerns were measured at baseline using the Pediatric Symptom Checklist-17, and anthropometric data were collected at baseline and treatment end. Paired-samples t-tests and mixed-effects repeated-measures analysis of covariance were utilized to examine psychological predictors of changes in body mass index percent of the 95th percentile (%95thpercentile) during treatment. Results: No differences in FBBT response based on race or ethnicity were identified. Findings indicated that a higher baseline %95thpercentile was associated with more internalizing, externalizing, and total psychological concerns. While youth in the intervention experienced a significant reduction in %95thpercentile from baseline to treatment end overall, youth with elevated baseline externalizing concerns did not exhibit significant decreases in %95thpercentile. Conclusions: FBBT was demonstrated to be equally effective across racial/ethnic groups, while significant differences were observed based on psychological concerns reported at baseline. This study highlights the utility of preliminary psychological screening to promote individualized care within pediatric obesity treatment.