Obesidade infantil: uma proposta de tratamento comportamental

• Autor(a) principal: Cruz, Maria Tereza Monteiro da
• Data de Publicação: 2012
• Tipo de documento: Dissertação
• Idioma: por
• Título da fonte: Biblioteca Digital de Teses e Dissertações da PUC_SP
• Texto Completo: https://tede2.pucsp.br/handle/handle/16684
• topic: Obesidade infantil; Economia de fichas; Adesão ao plano alimentar; Linha de base múltipla; Childhood obesity; Token economy; Adherence to nutritional orientation; Multiple base line; CNPQ::CIENCIAS HUMANAS::PSICOLOGIA::PSICOLOGIA EXPERIMENTAL

The objective of this work was to evaluate a program of token economy to modify the behavior of obese children. Two male youngsters aged 10 and 11 years old and an adolescent girl aged 15 years old participated in the research, all of whom where above the desired weight and sought a non-profitable organization aimed at treating childhood obesity and their mothers. The researcher lent a movie camera to the participants and asked that P1 filmed lunch and dinner five times a week and asked that P2 and P3 filmed breakfast, lunch and dinner every day of the week. The videos were delivered weekly to the researcher, who categorized the adherence to the food orientation provided by the nutritionist from the non-profitable organization in three classes: total adherence, partial adherence and non-adherence. An independent observer categorized 20% of each participant s videos to calculate the agreement between the researchers. Initially, it was only taken observation and register of the adherence to the nutritional orientation for all the participants. Besides the video analysis, the researcher interviewed the participants three times a week, asking about the quality and quantity of the food and number of meals made on the day before. After the adherence to the nutritional orientation reached stability in lunch and dinner for P1, eventually reaching stability on the three filmed meals for P2 and P3, their mothers received instruction to give tokens to their children when they served themselves according to the nutritional orientation then exchanging the tokens for tangible items preferred by de youngsters. After P1 adhered to the nutritional orientation, his mother received instruction to give tokens for the adherence to the morning and afternoon snacks according to the Multiple Base Line design and to suspend the tokens in the lunch and dinner. P1 s mother suspended their participation in the study before it was possible to observe any weight loss. P2 and P3 were submitted to the Base Line and Reinforcement phase of the adherence to the nutritional orientation in breakfast, lunch and dinner. The results showed a better quality of food consumption for all participants after the token delivery for the adherence to the nutritional orientation. Despite that, P1 gained weight during the study, remaining in the obesity classification. P2 lost weight but not enough to abandon the obese classification. P3 was the participant who lost the largest amount of weight, reaching a normal weight for his age. The intra-subject applied also showed the necessity to create a individualized procedure, considering the idiosyncrasies of the participants. The data also showed the importance of the family, offering adequate food, avoiding excessive caloric food and with low nutritional quality and reinforcing healthy feeding behavior