The effectiveness of a health promotion and stress-management intervention program in a sample of obese children and adolescents

Hormones (Athens). 2018 Sep;17(3):405-413. doi: 10.1007/s42000-018-0052-2. Epub 2018 Aug 11.


Objective: Our study aimed to evaluate the effectiveness of an 8-week stress management intervention program that included progressive muscle relaxation, diaphragmatic breathing, guided imagery, and cognitive restructuring in obese Greek children and adolescents.

Design: Thirty-six patients were prospectively recruited to participate in this randomized controlled study. Of these, 16 participants formed the intervention group and 20 participants the control group. Anthropometric measurements and salivary cortisol, determined serially 3 times a day, were assessed at the beginning and at the end of the study. Participants also completed the state-trait anxiety in children questionnaire (STAIC), the stress in children questionnaire (SiC), and the child behavior checklist (CBCL).

Results: The intervention resulted in a significant reduction of waist-hip ratio (p = 0.008) in the intervention group compared with the control group. Moreover, school performance was improved in the intervention group (p = 0.025), while both the intervention and the control group adopted healthier daily habits (p = 0.020 and 0.011, respectively). However, there was no statistically significant difference between body mass index (BMI) z-score, stress, anxiety, and diurnal patterns in salivary cortisol.

Conclusions: The present study supports the effectiveness of stress management intervention programs on waist-hip ratio reduction. Further research is required to investigate biomarkers able to predict and evaluate the effectiveness of stress management intervention programs.

Keywords: Adolescents; Anxiety; Children; Cortisol; Obesity; Stress.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adolescent
  • Breathing Exercises / methods*
  • Child
  • Cognitive Behavioral Therapy / methods*
  • Female
  • Health Promotion / methods*
  • Humans
  • Imagery, Psychotherapy / methods*
  • Male
  • Muscle Relaxation / physiology
  • Outcome Assessment, Health Care*
  • Pediatric Obesity / rehabilitation*
  • Program Evaluation
  • Relaxation Therapy / methods*
  • Stress, Psychological / therapy*