Effects of Behavior Modification on Physical Variables, Habit and Self-esteem in Obese Elementary School Children

행동교정요법이 비만아동의 신체지수, 습관 및 자아존중감에 미치는 효과

Behavior modification is an approach to decrease degree of obesity through changing maladaptive eating habit and life style. It produces small amount of weight loss but it has few side effects and low dropout rate. It also has great effectiveness on maintenance of decreased weight. This study was performed to investigate effects of behavior modification on physical variables, fat and thin habit, and self-esteem in obese elementary school children. Sixty two students of 4th, 5th, and 6th grade were selected from two elementary schools located in the suburbs of Seoul. Thirty four children in one school were assigned to experimental group and twenty eight children in another school were assigned to control group. All subjects were healthy and were not on any type of obesity control. Behavior modification, in this study, was consisted of introduction, self-monitoring and stimuli control, education about diet and physical activities, individual counseling and reinforcement, requesting personal assistance, cognitive restructuring, and closing and long-term planning. Experimental group was received 60～70 minutes of behavior modification once a week for 8 weeks from October 16 to December 22, 2000. Control group was not received any intervention. Data were collected before and after intervention by measuring physical variables, fat and thin habit, and self-esteem. Physical variables consisted of obesity index, skinfold thickness, body fat(percentage of body fat, fat mass, fat free mass), serum lipids(total cholesterol, HDL-C, LDL-C, triglyceride) and serum leptin. The results were as follows ; 1. physical variables 1) Obesity index of the experimental group was significantly decreased after behavior modification. But there was no significant difference between two groups. 2) The increase of skinfold thickness was significantly low in the experimental group compared to the control group. 3) Percentage of body fat and fat mass were significantly decreased in the experimental group. Fat free mass was significantly increased in the experimental group. 4) Total cholesterol, HDL-C, triglyceride and serum leptin between the experimental group and control group showed no significant difference. LDL-C was significantly decreased in the control group. 2. Thin habit score was significantly increased in the experimental group. In subcategories of habit, thin scores of life style, attitude, social relationship, nutrition were signifi- cantly increased in the experimental group. 3. Self-esteem score was significantly increased in the experimental group. These results indicate that behavior modification is effective in decreasing percentage of body fat and fat mass, in less increasing skinfold thickness and in increasing fat free mass, thin habit, and self-esteem. In conclusion, behavior modification can be used as safe and effective strategy for managing obesity in elementary school children.