Commentary: empirically supported treatments for pediatric obesity: goals, outcome criteria, and the societal context

weight, health, and social and psychological context are relevant to children and adolescents as well. A particular concern with this population is the suggested relationship between weight loss efforts and the onset of eating disorders. This is an arena that itself requires continuing, developmentally sensitive research (cf. Smolak, Levine, & Striegel-Moore, 1996). Thus, for the clinician, the questions of what is a desirable weight and how should treatment goals be defined remain at issue. When one adopts the perspective of a researcher, many of the same concerns emerge in the form of the identification of predictor variables in the treatment of obesity. In relation to these predictor variables, questions of differential outcome and the contribution of particular components to treatment effectiveness remain to be explored. The selection of criteria for evaluating treatment outcome is intimately related to conclusions derived from such research. A research focus also highlights the issue of the time frame in which one evaluates treatment and an appreciation that different variables may influence short-term and long-term outcomes. Furthermore, the pattern of individual weight history in the years preceding the initiation of treatment may influence considerations of treatment goals and evaluations of the effectiveness of various components (cf. Israel, Guile, Baker, & Silverman, 1994). The findings reported in the review of childhood obesity treatment are encouraging and important. However, our training as researchers and Journal of Pediatric Psychology, Vol. 24, No. 3, 1999, pp. 249–250