Psychiatric Problems in Obese Children Followed up for 10 Years-Reply

Abstract

To the Editor.— The report by Epstein et al, 1 Ten-Year Follow-up of Behavioral, Family-Based Treatment for Obese Children, notes long-term positive results with that mode of treatment applied to 76 selected patients: obese children with intact families, no history of psychiatric contact, at least one obese parent, and one parent willing to attend treatment meetings. Noted by the authors, but otherwise overlooked in the discussion of the outcome of this study, were the psychopathological effects that occurred among these 76 supposedly psychologically healthy children. Near the beginning of the study, one of the 76 children was dropped because of unreported psychiatric problems. During the second 5 years, six of the 67 children who were still eligible for the study developed significant psychiatric problems that required hospitalization and long-term medication use. Three children had manic-depressive illness, two had major depression with suicide attempts, and one developed an eating disorder. Finally,