European Child & Adolescent Psychiatry

, Volume 19, Issue 2, pp 135–141 | Cite as

Does inhibitory control capacity in overweight and obese children and adolescents predict success in a weight-reduction program?

  • Ursula Pauli-Pott
  • Özgür Albayrak
  • Johannes Hebebrand
  • Wilfried Pott
Original Contribution


It has been assumed that inhibitory control capacity might influence the success of overweight or obese subjects in reducing weight. However, empirical research on this association is scarce. The present study, therefore, examines whether success in an outpatient weight-reduction program for children and adolescents can be predicted by pre-intervention inhibitory control capacity. The study sample consisted of 111 overweight and obese children and adolescents (7.5–15 years) who attended an outpatient weight-reduction program of 1 year’s duration. Inhibitory control was assessed by two computerized neuropsychological procedures, a Go-NoGo and an interference task. Principal component analysis revealed “impulsivity” (fast but less valid reactions) and “inattention” (slow and highly variable reaction times) component. Those who succeeded in the intervention (losing more than 5% of BMI-SDS; n = 63) scored significantly higher in the first component than those who failed, while controlling for pre-intervention BMI-SDS, age, gender, and maternal education level. The association was moderated by age. Although in younger children no effect was found, in adolescents high “impulsivity” predicted success. Our result supports the scant evidence for a role of inhibitory control. However, further studies are required to substantiate that weak inhibitory control, and thus high reactivity to external cues, entails a better outcome in behavior modification interventions.


Executive functions Cognitive control Obesity Weight reduction program Impulsivity Inattention Neuropsychological assessment 


  1. 1.
    Allan J, Johnston M, Campbell N (2008) Why do people fail to turn good intentions into action? The role of executive control processes in the translation of healthy eating intentions into action in young Scottish adults. BMC Public Health 8:123CrossRefPubMedGoogle Scholar
  2. 2.
    Anderson P (2002) Assessment and development of executive function (EF) during childhood. Child Neuropsychol 8:71–82PubMedGoogle Scholar
  3. 3.
    Appelhans BM (2009) Neurobehavioral inhibition of reward-driven feeding: implications for dieting and obesity. Obesity 17:640–647CrossRefPubMedGoogle Scholar
  4. 4.
    Brocki KC, Bohlin G (2004) Executive functions in children aged 6 to 13: a dimensional and developmental study. Dev Neuropsychol 26:571–593CrossRefPubMedGoogle Scholar
  5. 5.
    Cole TJ (1990) The LMS method for constructing normalized growth standards. Eur J Clin Nutr 44:45–60PubMedGoogle Scholar
  6. 6.
    Drechsler R, Brandeis D, Földenyi M, Imhof K, Steinhausen H-C (2005) The course of neuropsychological functions in children with attention deficit hyperactivity disorder from late childhood to early adolescence. J Clin Psychol Psychiatry 46:824–836CrossRefGoogle Scholar
  7. 7.
    Eigsti I-M, Zayas V, Mischel W, Shoda Y, Ayduk O, Dadlan MB, Davidson MC, Aber JL, Casey BJ (2006) Predicting cognitive control from preschool to late adolescence and young adulthood. Psychol Sci 17:478–484CrossRefPubMedGoogle Scholar
  8. 8.
    Ellis LK, Rothbart MK, Posner MI (2004) Individual differences in executive attention predict self-regulation and adolescent psychosocial behaviors. Ann N Y Acad Sci 1021:337–340CrossRefPubMedGoogle Scholar
  9. 9.
    Földenyi M, Imhof K, Steinhausen H-C (2000) Klinische Validität der computerunterstützten TAP bei Kindern mit Aufmerksamkeitsdefizit-/Hyperaktivitätsstörungen. Zeitschr f Neuropsychologie 11:154–167CrossRefGoogle Scholar
  10. 10.
    Garon N, Bryson SE, Smith IM (2008) Exekutive function in preschoolers: a review using an integrative framework. Psychol Bull 134:31–60CrossRefPubMedGoogle Scholar
  11. 11.
    Gollwitzer PM (1999) Implementation intentions: strong effects of simple plans. Am Psychol 54:493–503CrossRefGoogle Scholar
  12. 12.
    Hall PA, Fong GT, Epp LJ, Elias LJ (2008) Executive function moderates the intention-behavior link for physical activity and dietary behavior. Psychol Health 23:309–326CrossRefGoogle Scholar
  13. 13.
    Holtkamp K, Konrad K, Müller B, Heussen N, Herpertz S, Herpertz-Dahlmann B, Hebebrand J (2004) Overweight and obesity in children with attention-deficit/hyperactivity disorder. Int J Obes 28:685–689CrossRefGoogle Scholar
  14. 14.
    Hupfeld J (1999) Logistische regression. Eine Einführung. Institut für Sozialpsychologie, Universität Bern, BernGoogle Scholar
  15. 15.
    Koschack J, Kunert HJ, Derichs G, Weniger G, Irle E (2003) Impaired and enhanced attentional function in children with attention deficit/hyperactivity disorder. Psychol Med 33:481–489CrossRefPubMedGoogle Scholar
  16. 16.
    Kromeyer-Hauschild K, Wabitsch M, Kunze D, Geller D, Geiss HC, Hesse V, von Hippel A, Jaeger U, Johnsen D, Korte W, Menner K, Muller G, Muller JM, Niemann-Pilatus A, Remer T, Schaefer F, Wittchen HU, Zabransky S, Zellner K, Ziegler A, Hebebrand J (2001) Percentiles of body mass index in children and adolescents evaluated from different regional German studies. Monatsschrift Kinderheilkunde 149:807–818CrossRefGoogle Scholar
  17. 17.
    Lam LT, Yang L (2007) Overweight/obesity and attention deficit and hyperactivity disorder tendency among adolescents in China. Int J Obes 31:584–590Google Scholar
  18. 18.
    Lengfelder A, Gollwitzer PM (2001) Reflective and reflexive action control in patients with frontal brain lesions. Neuropsychology 15:80–100CrossRefPubMedGoogle Scholar
  19. 19.
    Lengua LJ (2002) The contribution of emotionality and self-regulation to the understanding of children’s response to multiple risk. Child Dev 73:144–161CrossRefPubMedGoogle Scholar
  20. 20.
    Luciana M, Conklin HM, Hooper CJ, Yarger RS (2005) The development of nonverbal working memory and executive control processes in adolescents. Child Dev 76:697–712CrossRefPubMedGoogle Scholar
  21. 21.
    Manly T, Anderson V, Nimmo-Smith I, Turner A, Watson P, Robertson IH (2001) The differential assessment of children’s attention: the test of everyday attention for children (TEA-Ch), normative sample and ADHD performance. J Child Psychol Psychiatry 42:1065–1081CrossRefPubMedGoogle Scholar
  22. 22.
    Mezzacappa E (2004) Alerting, orienting, and executive attention: developmental properties and sociodemographic correlates in an epidemiological sample of young, urban children. Child Dev 75:1373–1386CrossRefPubMedGoogle Scholar
  23. 23.
    Nederkoorn C, Jansen E, Mulkens S, Jansen A (2006) Impulsivity predicts treatment outcome in obese children. Behav Res Ther 45:1071–1075CrossRefPubMedGoogle Scholar
  24. 24.
    Nigg JT (2005) Neuropsychological theory and findings in attention-deficit/hyperactivity disorder: the state of the field and salient challenges for the coming decade. Biol Psychiatry 57:1424–1435CrossRefPubMedGoogle Scholar
  25. 25.
    Nigg JT (2000) On inhibition/disinhibition in developmental psychopathology: views from cognitive and personality psychology and a working inhibition taxonomy. Psychol Bull 126:220–246CrossRefPubMedGoogle Scholar
  26. 26.
    Pott W, Albayrak Ö, Hebebrand J, Pauli-Pott U (2008) Treating childhood obesity: family background variables and the child’s success in a weight-control intervention. Int J Eat Disord (in press)Google Scholar
  27. 27.
    Reinehr T, Brylak K, Alexy U, Kersting M, Andler W (2003) Predictors to success in outpatient training in obese children and adolescents. Int J Obes Relat Metab Disord 27:1087–1092CrossRefPubMedGoogle Scholar
  28. 28.
    Summerbell CD, Ashton V, Campbell KJ, Edmunds L, Kelly S, Waters E (2003) Interventions for treating obesity in children. Cochrane Database Syst Rev 2003:Art.No.: CD001872Google Scholar
  29. 29.
    Tucha O, Walitza S, Mecklinger L, Sontag T-A, Kübber S, Linder M, Lange KW (2006) Attentional functioning in children with ADHD—predominantly hyperactive-impulsive type and children with ADHD—combined type. J Neural Transm 113:1943–1953CrossRefPubMedGoogle Scholar
  30. 30.
    Waring E, Lapane KL (2008) Overweight in children and adolescents in relation to attention-deficit/hyperactivity disorder: results from a national sample. Pediatrics 122:e1–e6CrossRefPubMedGoogle Scholar
  31. 31.
    Weiss RH (1998) Grundinteligenztest Skala 2 (CFT20). Hogrefe, GöttingenGoogle Scholar
  32. 32.
    Zimmermann P, Fimm B (2002) Testbatterie zur Aufmerksamkeitsprüfung. PsytestGoogle Scholar

Copyright information

© Springer-Verlag 2009

Authors and Affiliations

  • Ursula Pauli-Pott
    • 1
  • Özgür Albayrak
    • 2
  • Johannes Hebebrand
    • 2
  • Wilfried Pott
    • 3
  1. 1.Institute of Medical PsychologyUniversity Medical Centre, Justus-Liebig University of GiessenGiessenGermany
  2. 2.Department of Child and Adolescent PsychiatryUniversity of Duisburg-EssenEssenGermany
  3. 3.Red Cross Children’s Hospital SiegenSiegenGermany

Personalised recommendations