Intervenção Multidisciplinar Baseada na Família: Emagrecimento, Estilos Parentais, Perfil Comportamental e Consumo Alimentar.

Abstract

Obesity is associated with physical inactivity and with high consumption of hyper caloric foods. In children, this disease, shows to be correlated with internalizing behavioral problems and, in addition, causes damage to most organic systems. The group of educational practices (Parental Styles) can reduce or increase the risk of children’s overweight. Family based behavioral treatments for overweight have been developed for over 25 years and short and long term results of these have show their efficacy. The purpose of this study was to build a child-oriented group intervention program and evaluate which of two family roles – mediator (the person aids in the loss of weight) or participant (when the person loses weight) – shows to be the most effective in the reduction of Body Mass Index (BMI). Thirty children with percentile 85 and ages between 8 and 12 years, and 26 caregivers with BMIs 25 participated in the study. The results showed that the children with mediator caregivers followed rules better and reduced their BMI the most. Playful strategies favored motivation and participation in the interventional multidisciplinary approach, which indicates the importance of the implanting programs that are appropriate to the child´s language. The second study evaluated eating habits and their relation to the Body Mass Index BMI) of 12 overweight children, ages 7 to 12 years, who participated in a psycho-educational multidisciplinary intervention program for children and their caregivers. The effects of two different types of the caregiver participation: either as a mediator or as a participant in the eating habits of children. Healthy and non-healthy option of food and drinks were offered in nine sacks. The results showed a higher consumption of non-healthy foods in all snacks. However, the children that reduced their BMI during the multidisciplinary intervention ate more healthy foods than the ones that did not lose weight, though they continued to eat non-healthy foods as well. Children from the mediator groups ate more healthy foods. Correlations between social competence and behavioral problems of caregivers and children, BMI and adherence of children were addressed in the third study. Results show a significant relationship between the child’s internalization of behavioral problems and the BMI as well as a relationship between the child’s and the caregivers behavioral problems. It is suggested that the child’s behavioral problem is a mediating variable between the caregivers behavioral problem and the child’s BMI, therefore becoming necessary the development interventions on the overweight problem which deal with the behavioral problems of both. The fourth study, finally verified through the Inventário de Estilos Parentais (IEP), the parental styles of 18 caregivers. These were divided into two groups: participants and the mediators. Changes in the caregivers parental practices after the implantation of the multidisciplinary program were also evaluated. We also verified correlations between parental style and the child’s BMI. Overall, in the initial IEP there was a prevalence of the Physically Abusive parental style. No significant statistical correlation was found between child’s BMI and parental styles. After the program the mediator caregivers showed better results at the final IEP.