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Family-based treatment of severe pediatric obesity: randomized, controlled trial
Melissa A Kalarchian1, Michele D Levine, Silva A Arslanian
1Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.
Insights
Family-based behavioral weight control significantly reduced severe pediatric obesity short-term. Long-term benefits were seen in children attending at least 75% of sessions, highlighting the importance of consistent engagement in childhood obesity management.
Area of Science:
- Pediatric Endocrinology
- Behavioral Medicine
- Public Health
Background:
- Severe pediatric obesity is a growing public health concern requiring effective management strategies.
- Family-based interventions are promising for addressing childhood obesity by involving the entire household.
Purpose of the Study:
- To evaluate the efficacy of a family-based behavioral weight control program for children with severe obesity.
- To assess the impact of the intervention on weight status, medical outcomes, and quality of life.
Main Methods:
- 192 children (8-12 years) with severe obesity were randomized to an intervention or usual care group.
- Assessments included percent overweight, blood pressure, body composition, waist circumference, and quality of life at baseline, 6, 12, and 18 months.
- Factors associated with weight change, including session attendance, were examined.
Main Results:
- The intervention group showed significant decreases in child percent overweight at 6 months compared to usual care.
- Improvements in medical outcomes were observed at 6 and 12 months.
- Children attending ≥75% of sessions maintained reduced percent overweight through 18 months.
Conclusions:
- Family-based behavioral weight control effectively reduces pediatric obesity in the short term.
- Consistent participation (≥75% attendance) is crucial for sustained weight management benefits in children.
- The intervention also improved medical parameters and quality of life.
Objective:
We evaluated the efficacy of family-based, behavioral weight control in the management of severe pediatric obesity.
Methods:
Participants were 192 children 8.0 to 12.0 years of age (mean +/- SD: 10.2 +/- 1.2 years). The average BMI percentile for age and gender was 99.18 (SD: 0.72). Families were assigned randomly to the intervention or usual care. Assessments were conducted at baseline, 6 months, 12 months, and 18 months. The primary outcome was percent overweight (percent over the median BMI for age and gender). Changes in blood pressure, body composition, waist circumference, and health-related quality of life also were evaluated. Finally, we examined factors associated with changes in child percent overweight, particularly session attendance.
Results:
Intervention was associated with significant decreases in child percent overweight, relative to usual care, at 6 months. Intent-to-treat analyses documented that intervention was associated with a 7.58% decrease in child percent overweight at 6 months, compared with a 0.66% decrease with usual care, but differences were not significant at 12 or 18 months. Small significant improvements in medical outcomes were observed at 6 and 12 months. Children who attended > or =75% of intervention sessions maintained decreases in percent overweight through 18 months. Lower baseline percent overweight, better attendance, higher income, and greater parent BMI reduction were associated with significantly greater reductions in child percent overweight at 6 months among intervention participants.
Conclusions:
Intervention was associated with significant short-term reductions in obesity and improvements in medical parameters and conferred longer-term weight change benefits for children who attended > or =75% of sessions.
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