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Agwuna, Ruth. Mentor Interview. 6 Oct. 2018.

This was a quick interview between the researcher and the researcher's mentor, Dr. Ruth
Ngozi Agwuna at the beginning stages of the researcher's research. The interviewer asked
questions that were based on the topics of childhood obesity and food allergies. Through the
interview, the researcher learned that seventy-five percent of Dr. Agwuna's patients are
overweight. The treatment performed is for the patient to change their lifestyle, which
includes monitoring their diet and increasing their physical exercise. Dr. Agwuna also makes
a contract with her patients and makes sure to have follow up appointments. Dr. Agwuna has
heard about Cognitive Behavioral Therapy, however would only recommend it to patients if
their insurance covered the costs. From the questions focused on food allergies, the researcher
learned the steps of diagnosing a food allergy, which first includes asking the patient for the
history of their reactions, then performing a physical exam, and finally performing a scratch
test with different allergens. Dr. Agwuna also provides immunotherapy to help eradicate a
food allergy from a patient, through introducing the substance in small quantities over a
period of time.
This interview was very helpful for the researcher. The statement made by Dr. Agwuna
about needing proper insurance to receive Cognitive Behavioral Therapy led to a possible path
of research, the reason why CBT was not included in all insurance polices and how to make it
more accessible.

Beck, Judith S. The Beck Diet Solution: Train Your Brain to Think Like a Thin Person.
Reprint, Oxmoor House, 2009.

Judith S. Beck, who is the daughter of Aaron Beck, wrote this book. Aaron Beck was the
creator of Cognitive Behavioral Therapy in the 1960s, With his daughter, Beck created the
Beck Institute, in which patients can learn different Behavioral Skills to overcome the illness
that they have. In this specific book, Judith S. Beck discusses the use of Cognitive Behavioral
Therapy in weight loss treatment. She discusses how people can have sabotaging thoughts
during the diet process, which can hinder successful results. Patients also need to learn the
difference between cravings and hunger, as once this distinction is made, it is easier to control
one's eating habits. The book outlines the treatment plan that a patient would go through in
trying to lose weight with the help of CBT. The plan covers the span of six weeks. During the
first two weeks the patients learns different behavioral skills to prepare for their diet. This
includes problem solving, goal setting, and monitoring. An example is patients may be asked
to write reasons why they are pricing the diet for encouragement. Weeks three and four
consist of the patient actively taking part of their diet. They are also asked to log the food and
calories they consume each day. The last two weeks, patients are suppose to fine tune the
different behavioral strategies they learned so they are able to use the skills for the rest of their
life.
This book was extremely helpful to the researcher because it provided the timeline one
may take when using CBT for obesity. However, there were some flaws with the book. The
book seemed to be written as a self-guidance method to readers instead of the recommended
therapy sessions between a trained professional and patient. Another source of possible bias
was that the daughter of the creator of CBT, meaning that this book could have been a way to
promote their program and institute, wrote this book. But counterclaim is that because Mr.
Beck’s daughter wrote this book, all the information was gained through a highly qualified
source.

Bradley, Robert H. “Child Care and Common Communicable Illnesses in Children Aged 37 to
54 Months.” NICHD Early Child Care Research Network, Oct. 2002,
https://jamanetwork.com/journals/jamapediatrics/fullarticle/481250.

This article is about a study conducted by National Institute of Child Health and
Human Development (NICHD) Early Child Care Research Network on the correlation
between child care and common communicable illnesses in children aged thirty-seven to fifty-
four months. The study was on 1100 participants. The results of this study were that children
who were thirty-seven to fifty-four months that were enrolled in childcare with more than six
other children had more cases of upper respiratory tract illness, gastrointestinal tract illness,
and ear infections. But the children that went into large childcare before age three had a
smaller risk of becoming ill compared to children that were not in large groups of children
care prior to age three.
This article is of value to the researcher because it would give the researcher an idea of
the patients seen in a pediatrician’s office. It a child is constantly sick, the researcher could
use the information in the article to give a background to the problem. The information can
also be given as an explanation to the parents.

Castelnuovo, Gianluca, et al. “Cognitive Behavioral Therapy to Aid Weight Loss in Obese
Patients: Current Perspectives.” Psychology Research and Behavior Management, June
2017.

This article is about the use of cognitive behavioral therapy to help with weight loss in
obese patients. The article covered obesity, and obesity caused by binge eating. The definition
of obesity is a body mass index that is greater than 30 kg/m2. There is tradition cognitive
behavioral therapy, and then there is enhanced CBT, enhanced focused CBT, behavioral
weight loss treatment, therapeutic education, acceptance, and commitment therapy. CBT is a
good treatment because obesity is related to psychological variables. CBT allows patients to
"focus on cognitive process, modify unrealistic weight goals and negative perceptions of body
image, and have behavioral modifications like chewing slowly."
This was a useful article to the researcher. The article is written in a clear way, making
it easy for the researcher to understand. The article includes a lot of definitions as well. Also
was article was recently written, making the information more reliable.

Center for Disease Control and Prevention. “About Child & Teen BMI.” About Child & Teen
BMI, https://www.cdc.gov/healthyweight/assessing/bmi/childrens_bmi/about_childrens_
bmi.html.

The Center of Disease Control and Prevention explains that a persons Body Mass Index
or BMI is that person's weight in kilograms divided by the square of height in meters. A
child's BMI also depends on their age as well as their sex. Then the BMI is expressed in a
percentile, and where that percentile falls determines the healthiness of the child. A BMI in
less than the fifth percentile is considered underweight, a BMI between the fifth percentile and
less than the eighty-fifth percentile is a healthy weight, and BMI that is in the eighty-fifth
percentile to less than the ninety-fifth percentile is considered overweight. And lastly, a BMI
that is in the ninety-fifth percentile and over is considered obese. The CDC also mentions the
different health risks and consequences of that come from childhood obesity. Children who
are obese are more likely to have high blood pressure and cholesterol, which is a risk factor of
cardiovascular disease. A study showed that 70% of obese children had one risk factor for
cardiovascular disease and then 39% percent had two or more risk factors. Obese children
have a higher change of glucose intolerance, insulin resistance, and type two diabetes. Other
physical health problems are sleep apnea, asthma, joint problems, musculoskeletal discomfort,
fatty liver disease, gallstones, gastro -esophageal reflex. Childhood obesity also as
psychological problems, for example stress, depression, behavioral problems, issues at school,
low self esteem, low self reported quality of life, and impaired social, physical, and emotional
functioning. Obese children will most likely become obese adults if they do not change their
lifestyle habits as a child. As an obese adult, they are more prone to heart disease, diabetes,
and some cancers.
This webpage was a very helpful resource to the researcher. It provided explanations and
resources on children's BMIs, including a calculator. The CDC also provides different
graphics, like the BMI chart for boys, detailing the different ranges for underweight, healthy,
overweight, and obese boys. This chart was used in the researchers slideshow presentation.

“Childhood Obesity Facts.” Centers for Disease Control and

Prevention, https://www.cdc.gov/healthyschools/obesity/facts.htm.

The CDC reported that in 2015, one in five children in young adults, aged six to nineteen,
sixteen to nineteen. Doctors determine a child's obesity by measuring the child's BMI, which
is a person's weight in kilograms divided by their height in meters. A child that has a BMI that
is over 85% and under 95% of that age is defined as overweight. Children that over 95%
percentile in their BMI is defined as obese.
This article was a basic article that was put out by a government agency, the CDC. It
provided the researcher will basic definitions.

Center for Disease Control and Prevention. Vaccines for Children Program (VFC).
https://www.cdc.gov/vaccines/programs/vfc/about/index.html#history.

This is the webpage explaining the Vaccines for Children program. The VFC is a
program run by the government that gives to children who are eligible free vaccines. Children
who are eligible are nineteen years old or younger, Medicaid-eligible, uninsured,
underinsured, American Indian, or Alaska Native. The Center for Disease Control buys the
vaccines at discount and then distribute them to doctor offices.
This was a helpful webpage to the researcher because a definition to the VFC program.
It also explained why some patients receive certain types of vaccines and some do not.

Cognitive Behavior Therapy Center in Silicon Valley. “Frequently Asked

Questions.” Cognitive Behavior Therapy Center in Silicon
Valley, http://cognitivebehaviortherapycenter.com/frequently-asked-questions/.
 The webpage is a question and answer page for a Cognitive Behavioral Therapy Center in
California. The center specializes in CBT and the therapists take part in training sessions once
a week to make sure that they are tailoring treatment to each individual patient. Different
questions asked on the page include, what is unique about CBT, the cost of CBT, and how
long does CBT take. At the clinic, patients usually come for sessions twelve to twenty
sessions over the course of three to six months. At the clinic, the cost per session ranges
between $175 to $290 with a licensed therapist.
The webpage is not the most scholarly source, however it does provide the researcher
prices for CBT sessions, which the researcher was having difficulty to find.

“Cognitive Behavioral Therapy (CBT) Resources.” DSC Health and

Wellness, https://opencuny.org/healthdsc/grad-student-wellness/cognitive-behavioral-
therapy-cbt-resources/.

This is a webpage that introduces what Cognitive Behavioral Therapy is and provides
different resources. Cognitive behavioral therapy is a goal orientated form of therapy that
focuses on the triangle between thoughts, emotions, and behavioral. Through the therapy
sessions, which are conducted with a therapist, patients learn to identify negative thoughts and
behaviors and shift their thinking to more positive ones. From changing from more negative to
positive, patients will also see how the three different parts of the triangle are all connected.
The researcher finds this website very useful. Included are different links for patients to
find resources like worksheets that will help them use cognitive skills. The website also
provides training guides for therapists who treating patients with CBT. The website also
includes a very nice diagram of the triangle with emotions, behaviors, and thoughts, which the
researcher used in a presentation.

Coppock, Jackson H., et al. “Current Approaches to the Management of Pediatric Overweight
and Obesity.” Current Treatment Options in Cardiovascular Medicine, vol. 16, Nov.
2014, doi:doi:10.1007/s11936-014-0343-0.

This article focuses on the current treatment plans used for childhood obesity. Currently,
the key aspects of effective treatment are, "early intervention, moderate- to high-intensity
intervention of sufficient duration, multi-component intervention targeting dietary
modification, physical activity and behavioral strategies, family involvement and goals
targeting family members, and follow-up contact during maintenance." If a child loses the
excess weight at a young age, then small losses in increments of time can bring a child to a
healthy weight. The article mentions how childhood is diagnosed, through determining the
BMI, as well as how it causes an increased risk in developing life-threatening diseases. The
article focuses on primary care intervention, family based lifestyle intervention and behavioral
treatment, and diet and physical activity targets. On primary care intervention, family
physicians and pediatricians have the opportunity for early identification of a child is
overweight or obese through the child's yearly exams. To help manage obesity, pediatricians
must provide treatment with interventionist support or else they may not be effective in
screening for obesity. Lifestyle interventions are "active treatments that focus on modifying
children's daily dietary and activity behaviors, targeting sustainable changes associated with
healthy weight management." Family based treatments should be moderate to high intensity.
Family-based behavioral treatment is a "multi-component lifestyle intervention that targets the
behaviors of both the child and the parent. The purpose is to create new healthy behaviors
within the home environment, which promote healthy eating and exercise. The recommended
diet for obese children is to have an increase in fruits and vegetables, whole grains, low-fat
and non-fat dairy products, beans, fish, and lean meats. Treatments should focusing on
reducing the intake of high fat and calories foods and possibly eliminating sugar-sweetened
beverages. A child should have at least sixty minutes of physical activity a day.
This was an useful article for the researcher. It provided the specifics on what doctors
recommend for obese patients. The researcher used this information in her research, especially
the focused diet as well as the physical activity.

Dietz, William H. “Health Consequences of Obesity in Youth: Childhood Predictors of Adult

Disease.” Pediatrics, Nov. 1997, pp. 518–25, doi:ISSN 0031 4005.

This article is about the consequences that children who are obese may face as a child to
when they are as an adult. The beginning of the article starts with the different social
consequences obese children may have. Starting with obese children usually being taller than
their non-overweight peers. This causes adults to mistake their age, and treat the children as if
they are older than they are. This may cause frustration to the child as they feel that they
cannot fulfill the expectations put upon them. The article also stated that the National
Longitude Survey of Youth conducted a study and found that women who were obese in their
adolescent and early adult years had fewer years of education, had a lower income, and had
lower rates of marriage. The medical consequences stated in the article are early growth,
hyperlipidemia, glucose intolerance, hepatic steatosis and cholelithiasis, hypertension,
pseudotomor cerebri, sleep apnea, and polycystic ovary disease. In early growth, early
maturation leads to increase of fatness in later life. In obese children there is an increased
blood lipids. There are elevated serum low- density lipoproteins, cholesterol and triglycerides
and lowered density lipoprotein, which causes the hyperlipidemia. Glucose intolerance and
diabetes are quite frequent in obese patients. There are high concentrations of liver enzymes in
obese patients. Obese patients have a higher risk of hypertension because high blood pressure
is nine times more frequent in obese patients. Pseudotumor Celebri is a rare disorder found in
childhood and adolescence. It is where there is increased intracranial pressure causing
headaches and possible blindness. 1/3 of the patients who are obese and have breathing
problems are more likely to have sleep apnea. And thirty percent of women with Polycystic
Ovary Disease are obese.
This article was quite helpful to the researcher. It stated the different possible diseases
and statistics. The only thing that was a little bit confusing was the last page. The article was
published twenty years ago, so the data may be not be as accurate.

Edwards, Paul N. “How to Read a Book.” University of Michigan School of Information,

https://pne.people.si.umich.edu/PDF/howtoread.pdf.

This article, written by Paul N. Edwards, describes the different ways and strategies
one should read to gain and retain information. The different strategies mentioned are to read
the whole thing, decide how much time to spend, have a purpose and strategy, read actively,
read it three times, focus on parts with high information content, use personal text markup
language, know the author and organizations, know intellectual context, use your uncurious
mind, and to rehearse and use multiple modes. Edwards says that it is important to understand
the main argument of the piece, finding evidence that support the argument as you read. He
also says that when reading, always markup the reading and make notes, so the reader would
be able to digest the information later. Edwards also wants the readers to focus on the high
quality information that is usually found at the beginning or end of the text or paragraphs. To
be able to truly master the strategies, the author makes it clear that they need to be practice
over a long period of time.
This article is very helpful, as it shows the researcher different ways to process
information in a long reading. It gives good strategies that will help save time.

Flores, Gleen, et al. “Pediatricians’ Attitudes, Beliefs, and Practices Regarding Clinical
Practice Guidelines: A National Survey.” Pediatrics Official Journal of the American
Academy of Pediatrics, vol. 105, no. 3, Mar. 2000,
http://www.pediatrics.org/cgi/content/full/105/3/496.

This article is about a study conducted on different pediatricians through out the
United States and Puerto Rico. The study was on the different attitudes and opinions that
pediatricians have on clinical practice guidelines. The results were that 35% of pediatricians
use the guidelines, 44% of pediatricians use them in part, while 21% do not use them at all.
The most common guidelines were used for asthma. The two most common reasons for using
clinical practice guidelines were for helpfulness and standardization of care. And the two most
common complaints about the clinical practice guidelines were failure for clinical judgment.
This article shows that some practices used by pediatricians may be by set guidelines,
allowing the researcher to learn treatment faster. Because of the set guidelines, there is a
procedure to different treatments. This article is about eighteen years old so the data may not
be as accurate to today's society.

Freedman, David S., et al. Relationship of Childhood Obesity to Coronary Heart Disease Risk
Factors in Adulthood: The Bogalusa Heart Study.
https://www.researchgate.net/profile/Gerald_Berenson/publication/11813590_Relationshi
p_of_Childhood_Obesity_to_Coronary_Heart_Disease_Risk_Factors_in_Adulthood_The
_Bogalusa_Heart_Study/links/54ba84f30cf253b50e2d02a2/Relationship-of-Childhood-
Obesity-to-Coronary-Heart-Disease-Risk-Factors-in-Adulthood-The-Bogalusa-Heart-
Study.pdf.

This article was about a study conducted on the correlation between childhood obesity
and the risk of coronary heart disease as an adult. Researches measured the 2617 children in
the community of Bogalusa located near New Orleans. When the participants were children
between the age of two and seventeen, their height, weight, and BMI levels were measured.
Then about seventeen years later, when the participants were eighteen to thirty-seven years
old, there levels of lipids, insulin, blood pressure, and their adult BMI were measured. The
results concluded that adults who were obese as a child were most likely to be overweight as
an adult (77%). While 7% of the normal weight children became obese as an adult. The
overall study showed that oversight children had an increased risk for adult morbidity and
mortality, particularly in coronary heart disease. However the study concluded that childhood
weight status did not independently related to adult risk fact levels.
 This article was not that helpful to the researcher. Because the study was performed in
2001, the results did not fully answer the hypothesis they were looking at. It was determined
in the study that more research would be needed to fully determine the effects of child obesity
on coronary heart disease.

Harvard T.H. Chan. “Obesity Prevention Source: Economic Costs.” Harvard T.H. Chan
School of Public Health, https://www.hsph.harvard.edu/obesity-prevention-
source/obesity-consequences/economic/.

This is a page written by the University of Harvard's School of Public Health. The
primary topic of the passage was the damaging effects that cases of obesity can cause the
United States economy. In the passages, "cases of obesity" relates to directly obesity costs, as
well as costs that come from obesity related conditions including heart disease, diabetics, and
some cancers. The United State's economy is spending billions of dollars each year to obesity
and obesity related costs. The costs calculated include direct and indirect costs. Direct costs
come form in patients and out patient heath surgery. Indirect costs include value of lost work,
insurance, and wages. It has been estimated that the United States spends $190 billion dollars
a year, and that number will only increase as the number for obese children and patients
increase within the United States.
This was a helpful page; it included data and other references to sources if needed.
However one element that was hard to understand in the passage was the measurement on the
number of dollars spent each year. At first there was an estimate of the cost for ac certain year.
Then the measurement changed to the increase of money per year. This made it hard to
compare the price gap between different years.

Jacob, Jubbin J., and Rajesh Isaac. “Behavioral Therapy for Management of Obesity.” Indian
Journal of Endocrinology and Metabolism, vol. 16, no. 1, 2012, pp. 28–32,
doi:10.4103/2230-8210.91180.

This article describes behavioral therapy on helping patients manage obesity. There was
an increase of 75% of patients that were enrolled in behavioral therapy programs from 1974 to
1994 in India. Evidence also shows that longer BT programs are more effective than shorter
ones. An eight week program led to an average of 3.5 kg weight loss compared to an average
of 8.5 kg by a twenty-one week program. The common components of behavioral therapy are
self-monitoring, stimulus control, slower eating, goal starting, behavioral contracting,
education, increasing physical activity, and social support. The different settings where once
could receive BT is in a clinic setting, self-help groups, commercial weight loss programs, and
Internet base programs. For an effective BT in obese children, there has to be parental
involvement and a reduction of the usage of technology, which leads to an increase of activity.
This article was very informative in behavioral therapy, describing the different
components of an effective treatment, and where a patient would get treatment. The article is
somewhat useful to the researcher, describing a different type of treatment for obese children.

Karr, Samantha. Epidemiology and Management of Hyperlipidemia. June 2017, p. 10,

https://www.ajmc.com/journals/supplement/2017/pcsk9-inhibitors-a-guide-for-managed-
care/epidemiology-and-management-of-hyperlipidemia-article?p=1.
 This article discusses the ways to treat and manage hyperlipidemia, which are elevated
cholesterol levels. Cardiovascular disease is the leading cause of death among adults in the
United States. However, people with hyperlipidemia have twice the risk of developing
cardiovascular disease compared to people with normal cholesterol levels. Hyperlipidemia is
the imbalance of cholesterol levels, including low-density lipoprotein cholesterol and high-
density lipoprotein cholesterol in the blood. These two lipoproteins regulate the amount of
cholesterol within the body, and when there is an imbalance it increases the risk of
cardiovascular health issues, for example myocardial infarction and stoke. if there is an
increase of low-density lipoprotein cholesterol then that may lead to the buildup of plaque
within the artery, causing coronary artery disease or a stroke. Factors that increase the risk of
developing hyperlipidemia include a diet high in saturated or trans fats, lack of physical
activity, smoking, and obesity. Secondary factors include biliary obstruction, chronic kidney
disease, type 2 diabetes, cyclosporine, and glucocorticoids.
This article was used in the articles research for extra information. Hyperlipidemia is a
disease that obese children have a higher risk of developing; therefore the researcher used
information from the abstract to enhance the paper. Any information in the body of the paper
was barely touched.

Katkin, Julie P., et al. “Guiding Principles for Team-Based Pediatric Care.” American
Academy of Pediatrics, vol. 140, no. 2, Aug. 2017,
http://pediatrics.aappublications.org/content/pediatrics/early/2017/07/19/peds.2017-
1489.full.pdf.

This article describes the need for team based pediatric care for children. Team based
pediatric care is a healthcare model that endorses partnerships between different professionals
(healthcare or other) to provide the best care for the child and its family. It is important for the
members of the team to all work together. Communication is key. This would involve having
frequent meetings to decide the different steps and plans that should be taken. If all the
members cannot meet physically, then members should use technology. The authors also
mention for team-based care to work, all members need to put the team's goals first before
their personal goals. They should also establish team leadership, which would usually be the
pediatrician. Members also need to be flexible to accommodate the different needs of different
members.
This article shows the best possible way to give proper care to patients. It shows the
researcher how they would be able to be able give the best services to their patients, and what
they should not do. It really exposed the strategy of team-based care.

Kelly, and Kirschenbaum. “Immersion Treatment of Childhood and Adolescent: The First
Review of a Promising Intervention.” International Association for the Study of Obesity,
Aug. 2009, doi:10.1111/j.1467-789X.2009.00710.

This article analyzes the effectiveness of immersion therapy, which could be summer
camps for overweight children. In this article, it looks at the effect of Cognitive Behavioral
therapy in these camps. Obesity in America has been on the rise. Sixteen percent of US
children are obese and eighteen percent are overweight. Overweight children are more likely
to become obese adults and develop life-threatening diseases. Overweight children also
suffer from stereotypes that can lead them to a decreased quality of life and increased
chances of depression, suicide, academic difficulties, vocational limitations, and social
challenges. Different types of treatments to prevent or help overweight children are
education, out-patient treatments, surgery, and immersion. Education treatments are not
found to be helpful because while they promote preventative measures, only 21% of patients
had targeted improvements to their BMI. Out-patient treatments are shown to provide
statistically and clinically significant long term effects. Short-term out-patient treatments are
more effective than longer ones. The surgery that is performed on overweight children is
called Bariatric surgery. It shows promise, however it is an extreme intervention for those
who are extremely overweight. Immersion therapies involve placing patients in a therapeutic
and education environment for extended periods of time, there is no complete analysis on the
effectiveness of this treatment. These immersion treatments place children on strict diet and
physical activity regulations. Along with that, some camps provide nutrition education and
therapy. Half of the camps reviewed in the paper offered Cognitive Behavioral therapy,
either in group sessions or individual. In these settings, therapists utilized CBT techniques for
managing behavioral change, in self monitoring, motivational interviewing, and problem
solving. Characteristics for the camps that included CBT were that they ran longer on
average (17.4 weeks,) catered to a slightly older age group (13.8 yrs.), and had no difference
in other camps in number of calories, amount of exercise, and amount of nutrition
instruction. CBT outperformed nonCBT camps in performance during intervention, between
intervention and follow up, and from pre treatment to follow up. There were greater
reductions in weight in CBT camps. CBT is useful because it helps to develop self-regulatory
skills like self monitoring, reduce negative states, and improve psychosocial function. CBT
helps parents help bring positive experiences by showing that their behaviors can affect their
outcome. "both overweight children and their families involved in CBT immersion treatment
could use the rapid and consistent weight losses the children experience as proof that ‘I can
do this! I can really lose this weight!’ "
This article was extremely useful to the researcher. It provided statistical evidence on the
benefits of Cognitive Behavioral Therapy. This will be one of the main articles that the
researcher will focus on to prove the need for CBT in weight loss treatment. This article also
provides many other resources for the researcher to look into. This paper is reliable in the
sense that in was written in the past ten years, however there may be some bias for the
effectiveness of immersion treatments for the two authors are employees of one of the
leading providers for immersion treatments.

Marcovitch, Harvey, editor. Black’s Medical Dictionary. 42nd ed., A&C Black Publishers
Ltd, 2010.

The dictionary provides a basic definition of Cognitive Behavioral Therapy. CBT is a

psychological talking based therapy. It originated from Aaron Beck in the 1960s when he
noted that in his depressed patients, their thoughts led to misinterpretation and distortion.
There is a relationship between thoughts, emotions, and behaviors. Therapy includes the
therapist and patient trying to work towards the patient's goals in time sessions. Typically
there is five to twenty, weekly sessions. Patients are encouraged to use the skills learned in
their sessions as "homework" in their day-to-day life. CBT is used for all different types of
disorders.
 This definition is useful for the researcher to help explain CBT to audience members or
readers. It helps provide an explanation that does not involves medical terminology, which
the audience may not yet know. This dictionary was helpful during the classroom
presentations.

Mayo Clinic. “Cognitive Behavioral Therapy.” Mayo Clinic,

https://www.mayoclinic.org/tests-procedures/cognitive-behavioral therapy/about/pac-
20384610.

This is a general article put out by the Mayo Clinic describing cognitive behavioral
therapy. The web page gave an overview, reasons for CBT, risks, how to prepare, what to
expect, steps, and how to get the most out of the sessions. Cognitive behavioral therapy is a
psychotherapy, which means talking with a mental health counselor. CBT allows a patient to
pinpoint their inaccurate and negative thinking so they can change how they respond to
situations, and respond in a more effective way. CBT is about identifying and then coping.
Cognitive behavioral therapy can be done in group sessions or one on one, and the sessions
usually last for about ten to twenty sessions. The steps in CBT are to “identify troubling
situations or conditions in your life,” “become aware of your thoughts, emotions, and beliefs
about these problems,” identify negative or inaccurate thinking,” and reshape negative or
inaccurate thinking.”
This webpage was useful to the researcher. It gave a good general overview of cognitive
behavioral therapy and how it affects the patient. By reading the article, it will allow the
researcher to understand more complex articles.

Mendelsohn, Janis S., et al. “Interview Strategies Commonly Used by Pediatricians.” Archives
of Pediatrics and Adolescent Medicine, Feb. 1999,
https://jamanetwork.com/journals/jamapediatrics/fullarticle/345156.

This article was on the different strategies pediatricians use to gain a close harmonious
relationship with their patients. The article was based off of survey that five hundred and
forty-seven pediatricians in the Chicago metropolitan area responded too. The survey
collected data between the different age groups (infants, toddlers, pre school, school children,
and adolescents) on where the child was located during the pediatric interview, if a parent was
present during the interview, the strategies used by the pediatrician to gain rapport with the
patient, if the patient gave the majority of their medical history, calming strategies used, and
they type of questions asked. During the pediatric interview, infants and toddlers were
commonly found on their parents' lap and adolescents were most likely found on the
examination table. When a child is a infant, toddler, and in preschool, a parent is more likely
to be in the room for the interview compared to school aged children and adolescents.
Different strategies used by a pediatrician to gain rapport and use to calm a patient was to
share toys, hold the child, engage in drawing prompts, and discussing interests and school
with them. Once a patient reached the age of preschool, they begin to tell the doctor more
about their medical history. And for the type of questions they asked, doctors would not start
to ask patients about drugs, alcohol, and sex till they were about twelve years old.
This article showed the researcher the different strategies doctors used to have a
comfortable relationship with their patient, therefore teaching the researcher different methods
they could use. Even though the article is a little data, the strategies taught in the article could
still be used today.

Neighmond, Patti. “Impact Of Childhood Obesity Goes Beyond Health.” Morning Addition,
28 July 2010, https://www.npr.org/templates/story/story.php?storyId=128804121.

This was a radio broadcast by NPR that discussed the different risks and consequences
that come from obesity. Philippa Clarke, an epidemiologist at the University of Michigan,
wanted to determine the outcomes of people who were overweight during their adolescents.
She concluded that those who were overweight as a teenager would also be likely to be
overweight during their adulthood. Those who are overweight are more likely to be on
welfare, homeless, and/or single. Kelly Brownell, a Yale psychologist, also discussed how
overweight people are more likely to be discriminated against by their weight. Obese children
are more likely going to be teased due to their weight. it is concluded that the environment
which a person lives in is a key to solving obesity.
This was somewhat informational. The broadcast merely provided information, but did
not provide the analysis with the information.

Pimenta, Filipa, et al. “Brief Cognitive-Behavioral Therapy for Weight Loss in Midlife
Women: A Controlled Study with Follow-Up.” International Journal of Women’s Health,
vol. 4, 2012, pp. 559–567, doi:10.2147/IJWH.S35246.

A study was conducted to see the effectiveness of Cognitive Behavioral Therapy on the
weight loss of women with a mean age of fifty-one years old. There were two groups, a
control group, which the ten women did not take part on Cognitive Behavioral Therapy, and
the experimental group of eleven women taking part in Cognitive Behavioral Therapy. Those
in the experimental group went through eight sessions of Cognitive Behavioral Therapy over
the course of twenty-six weeks. There were three stages of this study. The first stage was T1,
which was one week before the intervention began, T2, which was one week after the
intervention concluded, and T3, which was a four-month follow up. The results of the study
showed that the mean weight loss during the four-month follow up was 3.1% of the baseline
weight in the Cognitive Behavioral Therapy group. Compared to the control group, which had
an increase of 1.2% of their baseline weight. For the women in the CBT group which had
binge eating disorder, at the fourth month follow up, their binge eating habits decreased, while
in the control group, binge eating habits remained the same. Women in the CBT group had a
lower weight, abdominal perimeter, and body mass index.
The study in this article was focused on the weight loss of midlife women, as shown by
the average age of fifty-one years old in participants. This is different then the age group,
which the researcher is focusing on, since the researcher, is looking at child obesity. The study
provided different charts which were detailed and showed their procedure and results in a
clear and organized way, which really helped the researcher.

Shabo, Yosef, et al. “Camel Milk for Food Allergies in Children.” The Israel Medical
Association Journal, vol. 7, Jan. 2006,
https://www.researchgate.net/publication/7388076.
 This article was written for the Israel Medical Association Journal. This was a study
conducted on the effects of using camel milk to improve the allergies in children. Eight
children were used in the experiment, and it ended with all eight children diminishing
symptoms to their allergens. Camel milk is said to be effective because the milk is vastly
different to ruminants for it is a Tylopoede. The milk contains 2% fat and knot beta
lactoglobulin. Camel milk is said to be very similar to the milk of a mother.
This article was very interesting. It showed a possible new way help the symptoms of
allergies in children, however the article never specifically said if the camel milk eradicated
the allergy from the child as there was no tests to prove it.

Stahre L1, et al. “A Randomized Controlled Trial of Two Weight-Reducing Short-Term

Group Treatment Programs for Obesity with an 18-Month Follow-Up.” International
Journal of Behavioral Medicine, Mar. 2007, pp. 48–55,
doi:10.1080/10705500701317070.

This article describes the study conducted on Cognitive Behavioral Therapy for weight
loss. There were two groups. The experimental group had Cognitive Behavioral Therapy as
part as their treatment and the control group's patients are treated with a behavioral program
and moderate exercise. The programs lasted for ten weeks, for two hours per week. Patients
were weighed periodically between eighteen months. At the end of the treatment, there was a
significant difference between weight loss. The mean weight loss of the Cognitive Behavioral
group was 8.6 kg, and at a follow up the average weight loss was 5.6. For the members of the
control group, their average weight loss was 07 kg, and at their follow up, they had an
increase of weight of 0.3 kg. This was a helpful study for the researcher. It provided data that
proved the effectiveness to Cognitive Behavioral Therapy compared to the control treatment
plan. The study was published twelve years ago; therefore it is still somewhat relevant.
However this study was conducted on middle age women and not children.

Stoddard, Jeffrey J., et al. “General Pediatricians, Pediatric Sub Specialists, and Pediatric
Primary Care.” Archives of Pediatrics & Adolescent Medicine, Aug. 1998,
https://jamanetwork.com/journals/jamapediatrics/fullarticle/189754.

This article was about the percentage of primary pediatric care given to patients by
general pediatricians versus sub specialist pediatricians. This experiment was conducted
through a questionnaire, which was given to 1616 active members of the American Academy
of Pediatrics, which 1145 of them responded. The definition given in the experiment to
classify a general pediatrician was someone who spent 80% of their time or more in general
pediatrics or adolescent medicine. The results were that general pediatrician indicated that
they provided 93% of the primary care delivered at their practice, and sub specialists only
delivered 2% of the primary care. However sub specialists indicated that they provided 32%
percent of the primary care, and general pediatricians provided 53%. The conclusion of the
experiment, that reasoning behind the two differing data was from the two different
perspectives. Meaning that the amount of primary pediatric care given to a patient had
different viewpoints depending if one identified as a specialist or general.
This source is useful because it showed the researcher the conflicting view between
general care pediatricians and sub specialists on the amount of primary care given to patients.
Therefore, if the researcher wanted to give more of primary care in the professional of a
pediatrician, then the researcher should focus on being a general pediatrician. However this
article relates more the profession choices of the researcher in a couple of years.

TEDx Talks. The Approach to Treating Childhood Obesity | Anita Vreugdenhil |

TEDxMaastricht. 2015, https://www.youtube.com/watch?v=IsMZmfEDupY.

This video is about a Ted Talk given by Anita Vreugdenhil, who is a Pediatric
Gastroenterologist at Maastricht University Medical Center. She is the founder of the
Maastricht program me COACH, a program that focuses on "all inclusive" strategies to
improve the lives of overweight children in the Netherlands. In her presentation, she describes
the common one-tool fits all method of helping obese children does not work. Instead of a
doctor telling a child to do exercise and eat right to fix their weight, the family, doctor, and
community member needs to work together to influence the child's lifestyle. For example,
instead of the soccer coach putting the overweight child as the goalie position, the coach
should make an effort to put the kid in a more active position, allowing the child to have
physical exercise.
This source is helpful to the researcher because it gives a overview of a more effective
treatment method to childhood obesity. It shows the researcher that while the treatment of
obesity seems simple, for it to work there must be a collaborative effort between difference
forces. This is a good source to possibly lead research on childhood obesity.

Viberti, Giancarlo, et al. “Prevalence and Concomitants of Glucose in European Obese

Children and Adolescents.” Diabetes Care, Jan. 2003,
doi:https://doi.org/10.2337/diacare.26.1.118.

This article shows the correlation between childhood obesity and glucose intolerance.
The increase of childhood obesity is associated to the increase rise in cases of type two
diabetes. The authors of the paper performed in a experiment in which studied glucose
intolerance and its effect on cardiovascular risk factors and its correlation to the degree of
obesity. This was tested on grossly obese children with an European origin. The researchers
studied 710 obese children and adolescents. There were 345 males and 365 females with ages
between six to eighteen years old. Of the obese children tested, one had diabetes, thirty had
impaired glucose tolerance, and two had impaired fasting glucose. The conclusions showed
that obesity has increased more with boys than with girls. With glucose levels, insulin
resistance and insulin secretory dysfunction contribute in raising glucose levels.
This research was not deeply used by the researcher. The abstract of the article was used
in the research of glucose intolerance in obese children, however the rest of article was barely
used. The different high level vocabulary words make it difficult for the researcher to
understand. This is because of the lack of emphasis of the effect of insulin on glucose
intolerance.

Wilfley, Denise E., et al. “A Randomized Comparison of Group Cognitive-Behavioral

Therapy and Group Interpersonal Psychotherapy for the Treatment of Overweight
Individuals With Binge-Eating Disorder.” Arch Gen Psychiatry, vol. 59, no. August
2002, pp. 713–21, doi:10.1001/archpsyc.59.8.713.
 The article describes a study that was conducted by the Joint Doctoral Program in
Clinical Psychology. The study was comparing two different treatment plans, Cognitive
Behavioral Therapy and Interpersonal Psychotherapy for Binge Eating Disorder. The
treatments consisted of twenty ninety minutes, weekly group sessions and three individual
sessions led by two therapists. For the treatment group working with Cognitive Behavioral
Therapy, there were three stages to their treatment. The first stage was for them to identify
times when they were overeating and to encourage normal eating habits. The second stage
was for the patients to learn cognitive skills to counter their negative thoughts and change the
stereotypes that they have on weight. The third and last stage was for the patients to prevent
lapse in their treatment by problem solving. They also did goal setting. The conclusion of this
study showed that in treating Binge Eating Disorder, both Cognitive Behavioral Therapy and
Interpersonal Psychotherapy both work as effective treatments. They both give the same
effects.
This article was helpful to the researcher. Even though the article was based on the study
comparing CBT and IPT, the researcher was able to use the description of the treatment plan
for CBT.

Wilfley, Denise E., et al. “Cognitive Behavioral Therapy for Weight Management and Eating
Disorders in Children and Adolescents E. Wilfley, Ph.D.A.” Child and Adolescent
Psychiatric Clinics of North America, vol. 20, no. 2, Apr. 2011, pp. 271–285,
doi:https://doi.org/10.1016/j.chc.2011.01.002.

This article is about the different treatments to use for patients with an eating disorder
or is obese. The article describes how Cognitive Behavioral Therapy is effective in the
treatment for weight management in children and adolescents. Cognitive Behavioral Therapy
emphasizes the "process of changing habits and attitudes that maintain psychological
disorder." Obesity can cause kids to have depression, feeling of worthlessness, low self
esteem, stigmatization, and teasing. The most effective treatment plan for obese children are
lifestyle intervention, which uses "a multi component approach to modify children's lifestyle
into healthy habits." CBT is used to target weight related behavior. The whole family needs to
get involved for the treatment to be effective.
This article was somewhat useful to the researcher. The researcher felt as if the article
showed that CBT worked better for those suffering a eating disorder. The article did not go in
to much on the effect of CBT for obese children.

Yuhasz, Louis. Weighing in - Solving the Obesity Crisis One Child at a Time: Louis Yuhasz at
TEDxCharleston. 2014, https://www.youtube.com/watch?v=wlZgE4SkAoM.

This Ted Talk was given by Louis Yuhasz, about the proper way to help childhood
obesity. Yuhasz begins the presentation with a story. His father died at age sixty-five from his
obesity, he was over 500 pounds. He could not get help at any hospitals because he was too
big for any of equipment. Yuhasz made it his lifelong goal to prevent any children from going
through the agony his father went through. Yuhasz mentions that the only way to save obese
kids from becoming obese adults is through teaching kids how to improve their lifestyles.
Make the children measure and keep track of their food intake, wear pedometers so they can
keep track of their steps. One of the biggest factors he stressed was getting cognitive
behavioral therapy for kids, so the kids could talk their feelings about being larger with an
adult.
This video was useful to the researcher. It emphasizes that to help obese kids it needs
to be a lifelong change. It also brings up cognitive behavior therapy, which does not seem to
be included in a lot of the treatment processes.