Investigation of the Effectiveness of the Psychoeducation Program Prepared for Adolescents with Exogenous Obesity

Öz

This study aims to examine the effectiveness of the intervention program for negative eating behaviours (emotional eating, impulsive eating, automatic eating) of adolescents with exogenous obesity. In order to determine the effectiveness of the program, a quasi-experimental design with 3x2 experimental and control groups and pretest-posttest measurements was used. The participants are adolescents aged 15-17, selected by purposeful sampling. A total of 60 people were included in the study, including 30 adolescents and one parent of each participant. The 14-week psychoeducation program was applied to the adolescents, and 9-week psychoeducation program was applied to the parents and the results were analyzed. As a result of the research, it was found that the intervention program caused a decrease in body mass indexes in the experimental groups, and the risk of obesity decreased in the group where families were included in the process. In general, the prepared psychoeducation program seems applicable and effective in the fight against obesity among adolescents. The conclusion that involving families in the process has a significant impact when combating obesity in adolescence is an important finding. Research findings were discussed in line with literature, and research suggestions were presented. It is recommended to conduct studies with large samples to confirm the effectiveness in different age groups.

Anahtar Kelimeler

• body mass index, emotion regulation, obesity, psychoeducation

Ekzojen Obezitesi Olan Ergenlere Yönelik Hazırlanan Psikoeğitim Programının Etkililiğinin İncelenmesi

Öz

Bu çalışmanın amacı, ekzojen obezitesi olan ergenlerin olumsuz yeme davranışlarına (duygusal yeme, dürtüsel yeme, otomatik yeme) yönelik hazırlanan müdahale programının etkililiğini incelemektir. Programın etkililiğini belirlemek amacıyla 3x2 deney ve kontrol gruplu, ön test-son test ölçümlü yarı deneysel tasarım kullanılmıştır. Katılımcılar, amaçlı örnekleme yoluyla seçilen 15-17 yaş arası ergenlerdir. Çalışmaya 30 ergen ve her katılımcının bir ebeveyni olmak üzere toplam 60 kişi dâhil edilmiştir. Ergen katılımcılara 14 haftalık, ebeveynlerine 9 haftalık bir psikoeğitim programı uygulanmış ve sonuçları analiz edilmiştir. Araştırma sonucunda müdahale programının deney gruplarında beden kitle indekslerinde düşüşe neden olduğu, ailelerin sürece dâhil edildiği grupta ise obezite riskinin azaldığı tespit edilmiştir. Genel olarak hazırlanan psikoeğitim programı ergenlerde obezite ile mücadelede uygulanabilir ve etkili olduğu görünmektedir. Ailelerin sürece dâhil edilmesinin ergenlikte obezite ile mücadele ederken önemli bir etkiye sahip olduğu sonucu önemli bir bulgudur. Araştırma bulguları literatür bilgileri doğrultusunda tartışılmış, araştırma önerileri sunulmuştur. Mevcut sonuçların ve farklı yaş gruplarında da etkililiğin doğrulanması geniş örneklemli çalışmaların yapılması önerilmektedir.

Anahtar Kelimeler

• beden kitle indeksi
• duygu düzenleme
• obezite
• psikoeğitim

Kaynakça

1. Altay, M., Cabar, HD & Altay, B. (2018). Ergenlik çağındaki çocuklarda beslenme ve okul sağlığı. Sinop Üniversitesi Sosyal Bilimler Dergisi, 2 (1), 173-180. https://doi.org/10.30561/sinopusd.414093
2. Akıncı, A. (2021) Ekzojen obezite. F. Darendeliler, Z. Aycan, C. Kara, S. Özen, S. & E. Eren (Ed.), Pediatrik Endokrinoloji ve Diyabet (ss.1236-1250). İstanbul Tıp Kitabevleri.
3. André, N., & Béguier, S. (2015). Using motivational interviewing as a supplement to physical activity program in obese adolescents: a RCT study. Eating and Weight Disorders-Studies on Anorexia, Bulimia and Obesity, 20(4), 519-523. https://doi.org/10.1007/s40519-015-0219-7
4. Anglé, S., Engblom, J., Eriksson, T., Kautiainen, S., Saha, M. T., Lindfors, P., Matti, L., & Rimpelä, A. (2009). Three factor eating questionnaire-R18 as a measure of cognitive restraint, uncontrolled eating and emotional eating in a sample of young Finnish females. International Journal of Behavioral Nutrition and Physical Activity, 6(1), 1-7. https://doi.org/10.1186/1479-5868-6-41
5. Atkinson, S. M., Denise, A., & Coia, W. (1996). The impact of education groups for people with schizophenia on social functioning and quality of life. British Journal of Psychiatry, 168(2), 199-204. https://doi.org/10.1192/bjp.168.2.199
6. Becker, S., Rapps, N., & Zipfel, S. (2007). Psychotherapie bei Adipositas-Ein systematischer Überlick. PPmP-Psychotherapie· Psychosomatik· Medizinische Psychologie, 57(11), 420-427. https://doi.org/10.1055/s-2007-986202
7. Beşikçi, A.O. (2010). Erken yaşta görülen obezite: Nedenleri ve tedbirler. Meslek İçi Sürekli Eğitim Dergisi, 23, 82-85.
8. Bhurosy, T., & Jeewon, R. (2014). Overweight and obesity epidemic in developing countries: a problem with diet, physical activity, or socioeconomic status?. The Scientific World Journal, (2014),1-7. https://doi.org/10.1155/2014/964236

9. Bjerkeset, O., Romundstad, P., Evans, J., & Gunnell, D. (2008). Association of adult body mass index and height with anxiety, depression, and suicide in the general population: the HUNT study. American Journal of Epidemiology, 167(2), 193-202. https://doi.org/10.1093/aje/kwm280
10. Booth, H. P., Charlton, J., & Gulliford, M. C. (2017). Socioeconomic inequality in morbid obesity with body mass index more than 40 kg/m2 in the United States and England. SSM-Population Health, 3(2017), 172-178. https://doi.org/10.1016/j.ssmph.2016.12.012
11. Boutelle, K. N., Braden, A., Knatz-Peck, S., Anderson, L. K., & Rhee, K. E. (2018). An open trial targeting emotional eating among adolescents with overweight or obesity. Eating Disorders, 26(1), 79-91. https://doi.org/10.1080/10640266.2018.1418252
12. Brown, C. L., Halvorson, E. E., Cohen, G. M., Lazorick, S., & Skelton, J. A. (2015). Addressing childhood obesity: opportunities for prevention. Pediatric Clinics, 62(5), 1241-1261. https://doi.org/10.1016/j.pcl.2015.05.013
13. Castelnuovo, G., Pietrabissa, G., Manzoni, G. M., Cattivelli, R., Rossi, A., Novelli, M., ... & Molinari, E. (2017). Cognitive behavioral therapy to aid weight loss in obese patients: current perspectives. Psychology Research and Behavior Management. 10, 165-173. https://doi.org/10.2147/PRBM.S113278
14. Cherry, A. L., Baltag, V., & Dillon, M. E. (2017). International handbook on adolescent health and development. Springer.
15. Cohen, J. (1988). Stastical power analysis fort he behavioral sciences. (2nd ed.). Lawrence Erlbaum Associates
16. Cooper, Z., Doll, H. A., Hawker, D. M., Byrne, S., Bonner, G., Eeley, E., O’Conner, M.E., & Fairburn, C. G. (2010). Testing a new cognitive behavioural treatment for obesity: A randomized controlled trial with three-year follow-up. Behaviour Research and Therapy, 48(8), 706-713. https://doi.org/10.1016/j.brat.2010.03.008
17. Cooper, Z., & Fairburn, C. G. (2001). A new cognitive behavioural approach to the treatment of obesity. Behaviour Research and Therapy, 39(5), 499-511. https://doi.org/10.1016/S0005-7967(00)00065-6
18. Cotter, E. W., Hornack, S. E., Fotang, J. P., Pettit, E., & Mirza, N. M. (2020). A pilot open-label feasibility trial examining an adjunctive mindfulness intervention for adolescents with obesity. Pilot and Feasibility Studies, 6(1), 1-11. https://doi.org/10.1186/s40814-020-00621-1
19. Crino, A., Greggio, N. A., Beccaria, L., Schiaffini, R., Pietrobelli, A., & Maffeis, C. (2003). Diagnosis and differential diagnosis of obesity in childhood. Minerva Pediatrica, 55(5), 461-470.
20. Daley, D. C., Bowler, K. ve Cahalene, H. (1992). Approaches to patient and family education with affective. Patient Education And Counseling, 19(2), 163-174. https://doi.org/10.1016/0738-3991(92)90195-O
21. Daubenmier, J., Kristeller, J., Hecht, F. M., Maninger, N., Kuwata, M., Jhaveri, K., Lustig, R. H., Kemeny, M., Karan, L., & Epel, E. (2011). Mindfulness ıntervention for stress eating to reduce cortisol and abdominal fat among overweight and obese women: an exploratory randomized controlled study. Journal of Obesity, 2011, 1–13. https://doi.org/10.1155/2011/651936
22. Garn, S. M., Sullivan, T. V., & Hawthorne, V. M. (1989). Fatness and obesity of the parents of obese individuals. The American Journal of Clinical Nutrition, 50(6), 1308-1313. https://doi.org/10.1093/ajcn/50.6.1308
23. George D., & Mallery M. (2019). IBM SPSS statistics 25 step by step: A simple guide and reference, (15th ed.). Routledge.
24. Gouveia, M. J., Frontini, R., Canavarro, M. C., & Moreira, H. (2014). Quality of life and psychological functioning in pediatric obesity: the role of body image dissatisfaction between girls and boys of different ages. Quality of Life Research, 23(9), 2629-2638. https://doi.org/10.1007/s11136-014-0711-y
25. Greenspoon, P. J., & Saklofske, D. H. (2001). Toward an integration of subjective wellbeing and psychopathology. Social Indicators Research, 54(1), 81–108. https://doi.org/10.1023/A:1007219227883
26. Ho, M., Garnett, S. P., Baur, L. A., Burrows, T., Stewart, L., Neve, M., & Collins, C. (2013). Impact of dietary and exercise interventions on weight change and metabolic outcomes in obese children and adolescents: a systematic review and meta-analysis of randomized trials. JAMA Pediatrics, 167(8), 759-768. https://doi.org/10.1001/jamapediatrics.2013.1453
27. Ihmels, M. A., Welk, G. J., Eisenmann, J. C., & Nusser, S. M. (2009). Development and preliminary validation of a Family Nutrition and Physical Activity (FNPA) screening tool. International Journal of Behavioral Nutrition and Physical Activity, 6(1), 1-10. https://doi.org/10.1186/1479-5868-6-14
28. Klesges, R. C., Stein, R. J., Eck, L. H., Isbell, T. R., & Klesges, L. M. (1991). Parental influence on food selection in young children and its relationships to childhood obesity. The American Journal of Clinical Nutrition, 53(4), 859-864. https://doi.org/10.1093/ajcn/53.4.859
29. Koletzko, B., Fishbein, M., Lee, W. S., Moreno, L., Mouane, N., Mouzaki, M., & Verduci, E. (2020). Prevention of childhood obesity: a position paper of the Global Federation of International Societies of Paediatric Gastroenterology, Hepatology and Nutrition (FISPGHAN). Journal of Pediatric Gastroenterology and Nutrition, 70(5), 702-710. https://doi.org/10.1097/MPG.0000000000002708
30. Miri, S. F., Javadi, M., Lin, C. Y., Griffiths, M. D., Björk, M., & Pakpour, A. H. (2019). Effectiveness of cognitive-behavioral therapy on nutrition improvement and weight of overweight and obese adolescents: A randomized controlled trial. Diabetes & Metabolic Syndrome: Clinical Research & Reviews, 13(3), 2190-2197. https://doi.org/10.1016/j.dsx.2019.05.010
31. Ozdemir S, Terzi O, & Dundar C. (2022). The family nutrition and physical activity (FNPA) screening tool: psychometric characteristics, reliability, and validity in the Turkish population. Journal of Public Health, 30(10), 2525-2531. https://doi.org/10.1007/s10389-021-01540-y
32. Öztürk, A., Borlu, A., Çiçek, B., Altunay, C., Horoz, D., … Şenol, V. (2011). Growth Curves in 0-18 Age Children and Adolescents (0-18 yaş çocuk ve adolesanlarda büyüme eğrileri). Turkish Journal of Family Practice, 15(3), 112-129. https://doi.org/10.2399/tahd.11.112
33. Pallant, J. (2016). SPSS Suvival manuel. A step by step guide to data analysis using IBM SPSS. (6th ed.). McGraw Hill education
34. Peckham, A. D., & Johnson, S. L. (2018). Cognitive control training for emotion-related impulsivity. Behaviour Research and Therapy, 105, 17-26. https://doi.org/10.1016/j.brat.2018.03.009
35. Petrillo, J. A., & Meyers, P. F. (2002). Adolescent dietary practices: a consumer health perspective. The Clearing House, 75(6), 293-296. https://doi.org/10.1080/00098650209603958
36. Polivy, J., & Herman, C. P. (1999). Distress and eating: why do dieters overeat?. International Journal of Eating Disorders, 26(2), 153-164. https://doi.org/10.1002/(SICI)1098-108X(199909)26:2<153::AID-EAT4>3.0.CO;2-R
37. Robertson, S. (2015). A positive psychological approach to weight loss and maintenance in obese Australians [Unpublished doctoral thesis]. University of Adelaide. https://hdl.handle.net/2440/98150
38. Rozehnalova, J. (2018). The role of positive psychology in the treatment of overweight and obesity, and its effects on molecular genetic pathways involved [Doctoral dissertation, University of Bolton]. Ethos. https://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.782450
39. Ryff, C. D., & Singer, B. (1998). The Contours of Positive Human Health, Psychological Inquiry, 9(1), 1-28. https://doi.org/10.1207/s15327965pli0901_1
40. Sandalcı, U., & Tuncer, G. (2020). Obezitenin doğrudan ve dolaylı maliyetlerine ilişkin bir değerlendirme. Aksaray Üniversitesi İİBF Dergisi, 12(2), 29-44.
41. Satman, I., Omer, B., Tutuncu, Y., Kalaca, S., Gedik, S., Dinccag, N., ... Tuomilehto, J. (2013). Twelve-year trends in the prevalence and risk factors of diabetes and prediabetes in Turkish adults. European Journal of Epidemiology, 28(2), 169-180. https://doi.org/10.1007/s10654-013-9771-5
42. Steinbeck, K. S., Lister, N. B., Gow, M. L., & Baur, L. A. (2018). Treatment of adolescent obesity. Nature Reviews Endocrinology, 14(6), 331-344. https://doi.org/10.1038/s41574-018-0002-8
43. Styne, D. M., Arslanian, S. A., Connor, E. L., Farooqi, I. S., Murad, M. H., Silverstein, J. H., & Yanovski, J. A. (2017). Pediatric obesity—assessment, treatment, and prevention: an Endocrine Society clinical practice guideline. The Journal of Clinical Endocrinology & Metabolism, 102(3), 709-757. https://doi.org/10.1210/jc.2016-2573
44. Suldo S.M., & Shaffer E.J. (2008). Looking beyond psychopathology: The dual-factor model of mental health in youth. School Psychology Review, 37(1), 52-68. https://doi.org/10.1080/02796015.2008.12087908
45. Thayer, R. E. (2003). Calm energy: How people regulate mood with food and exercise. Oxford University Press.
46. Tremmel, M., Gerdtham, U. G., Nilsson, P. M., & Saha, S. (2017). Economic burden of obesity: a systematic literature review. International Journal of Environmental Research and Public Health, 14(4), 435. https://doi.org/10.3390/ijerph14040435
47. Tuomisto, T., Tuomisto, M. T., Hetherington, M., & Lappalainen, R. (1998). Reasons for initiation and cessation of eating in obese men and women and the affective consequences of eating in everyday situations. Appetite, 30(2), 211-222. https://doi.org/10.1006/appe.1997.0142
48. Tura, G. (2014). Yapısal aile sistemleri kuramı temelli psikoeğitim programının aile ortamı, yeme tutumu ve obeziteye etkisi: vaka çalışması [Doktora Tezi]. Sakarya Üniversitesi.
49. Turner, H.M., Rose, K.S., & Cooper, M.J. (2005). Schema and parental bonding in overweight and nonoverweight female adolescents. International Journal of Obesity, 29(4), 381-387. https://doi.org/10.1038/sj.ijo.0802915
50. Vasques, C., Magalhães, P., Cortinhas, A., Mota, P., Leitão, J., & Lopes, V. P. (2014). Effects of intervention programs on child and adolescent BMI: a meta-analysis study. Journal of Physical Activity and Health, 11(2), 426-444. https://doi.org/10.1123/jpah.2012-0035
51. Wilson, P. W., D'Agostino, R. B., Sullivan, L., Parise, H., & Kannel, W. B. (2002). Overweight and obesity as determinants of cardiovascular risk: the Framingham experience. Archives of Internal Medicine, 162(16), 1867-1872. https://doi.org/10.1001/archinte.162.16.1867
52. Wong, E. M., & Cheng, M. M. (2013). Effects of motivational interviewing to promote weight loss in obese children. Journal of Clinical Nursing, 22(17-18), 2519-2530. https://doi.org/10.1111/jocn.12098