Dysfunctional eating behaviors in children aged 6-12 years with obesity. The effect of an intensive healthy behavioral lifestyle treatment

Obesity is a chronic, relapsing, multifactorial, and non-communicable disease marked by excessive adipose tissue accumulation and an increased risk of physical and psychosocial complications. In recent decades, its prevalence has reached epidemic levels, affecting children at an alarming rate. In Italy, the latest OKkio alla Salute report (2023) shows that 19% of children aged 8–9 are overweight, 9.8% are obese, and 2.6% meet criteria for severe obesity. This situation highlights the urgent need for effective, long-term interventions starting in childhood, in line with current international guidelines recommending structured, multidisciplinary approaches such as the Intensive Healthy Behavioural Lifestyle Treatment (IHBLT). This thesis is part of the broader Resilient Project (Reprogramming of Energy Homeostasis in Overweight Children and Adults through Physical Activity, Cognitive Stimulation, and Social Engagement), conducted at Bambino Gesù Children’s Hospital and funded by Italy’s National Recovery and Resilience Plan (PNRR). The project aims to adopt a holistic strategy to manage pediatric overweight and obesity by combining physical activity, memory training, and social interaction—drawing from preclinical studies suggesting a link between cognitive engagement and improved appetite regulation. The study evaluates the effectiveness of an intensive educational intervention, inspired by IHBLT principles, in promoting healthy eating behaviors and adequate physical activity in children aged 6 to 12 with overweight or obesity. It assesses changes not only in anthropometric measures but also in eating behavior outcomes. Moreover, it explores the possible modulation of hormonal pathways involved in appetite regulation, hypothesizing that their involvement could enhance the clinical benefits of behavioral interventions.