Subtyping children and adolescents who are overweight: Different symptomatology and treatment outcomes.

Children and adolescents who are overweight are a heterogeneous group. Whether pretreatment characteristics, such as dietary restraint and psychopathology, are related to differential treatment outcomes was not studied before. Using cluster analysis, the authors of this study examined the validity of subtyping along dietary restraint and internalizing psychopathology in 2 independent samples of treatment-seeking children and adolescents who were overweight (Study 1: n = 200; Study 2: n = 120). Three subtypes emerged: a dietary restraint/internalizing (DR/IN) group, a pure internalizing (IN) group, and a nonsymptomatic (NS) group. The DR/IN subtype showed more problems than the NS subtype, with complete consistency across the 2 studies for 1/4 of the validating variables. Although total weight change was not different across subtypes, compared with NS, the DR/IN and IN subtypes had a less positive weight prognosis during follow-up. Restraint scores only showed increases over time in the initially low-restraint IN group. These findings suggest that individual characteristics, such as degree of dietary restraint and internalizing psychopathology, can be useful in (a) classifying children and adolescents who are overweight, (b) stipulating specific treatment guidelines, and (c) making differential prognoses.