*5.1. Weight Loss, Diet, Behavioral Therapy, Lifestyle Modification*

Most organizations support weight maintenance or weight loss as a treatment goal for the management of pediatric obesity. Lifestyle intervention programs for youth with some degree of overweight recommend considering a wide multidimensional approach covering eating and dietary habits. Suffering from weight-related teasing during childhood and adolescence might lead to emotional eating which, in turn, could impair long-term weight loss maintenance [76]. Even when programs aiming to treat shared risk factors did not result in significant differences in terms of weight status, it had an impact on body dissatisfaction, dieting and weight-control behaviors [22].

Cognitive behavioral therapy (CBT) emphasizes on restructuring of the harmful patterns that infiltrate daily functioning and changing habits and attitudes that maintain psychological disorders. CBT has been suggested as a promising treatment approach for EDs and obesity [77]. However, CBT would be considered as a second-line option when family-based multicomponent behavioral weight loss treatment (FBT) has not been effective or could not be applied [77,78].

Multicomponent interventions are regarded to have higher rates of weight loss. FBT is considered effective at treating childhood obesity and a treatment option for disordered eating and obesity in children [79]. Compared to an adolescent-focus intervention, a healthy family-based lifestyle modification could result in increased sustainably of changes [27]. The results of a clinical trial including adolescents on 4-month FBT and subsequent 8-month weight maintenance interventions showed that weight change following FBT and maintenance were reported to be independent of concurrent physiopathology and EDs in the short or long term [80].
