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Ten-year follow-up of behavioral, family-based treatment for obese children
L H Epstein1, A Valoski, R R Wing
1Department of Psychiatry, University of Pittsburgh School of Medicine, PA 15213-2593.
Insights
Behavioral family-based treatment significantly reduced overweight in obese children over 10 years. Parent and child involvement in behavioral treatment yielded the best long-term weight management results.
Area of Science:
- Pediatric Obesity
- Behavioral Health
- Longitudinal Studies
Background:
- Childhood obesity is a growing public health concern.
- Effective long-term interventions are crucial for managing pediatric obesity.
Purpose of the Study:
- To evaluate the 10-year effects of behavioral family-based treatment on overweight and growth in obese children.
- To compare different reinforcement strategies within a behavioral treatment framework.
Main Methods:
- Prospective, randomized, controlled trial involving obese children aged 6-12 years and their parents.
- Three groups: child and parent reinforcement, child-only reinforcement, and nonspecific control (attendance reinforcement).
- All groups received similar diet, exercise, and behavior management training.
Main Results:
- The child and parent group demonstrated significant decreases in percent overweight at 5 and 10 years (-11.2% and -7.5%).
- The child-only group showed intermediate results, with increases in percent overweight (+2.7% and +4.5%) not significantly different from other groups.
- The nonspecific control group showed significant increases in percent overweight (+7.9% and +14.3%) over 10 years.
- Child height at 10 years correlated strongly with same-sex parent height (r=0.78), with no group differences in height.
Conclusions:
- Behavioral family-based treatment, particularly when reinforcing both parent and child, is effective for long-term overweight reduction in obese children.
- Parental involvement is key to successful pediatric weight management interventions.
- Growth trajectories, specifically height, are primarily influenced by parental genetics rather than the intervention type.
Abstract:
Using a prospective, randomized, controlled design, we examined the effects of behavioral family-based treatment on percent overweight and growth over 10 years in obese 6- to 12-year-old children. Obese children and their parents were randomized to three groups that were provided similar diet, exercise, and behavior management training but differed in the reinforcement for weight loss and behavior change. The child and parent group reinforced parent and child behavior change and weight loss, the child group reinforced child behavior change and weight loss, and the nonspecific control group reinforced families for attendance. Children in the child and parent group showed significantly greater decreases in percent overweight after 5 and 10 years (-11.2% and -7.5%, respectively) than children in the nonspecific control group (+ 7.9% and + 14.3%, respectively). Children in the child group showed increases in percent overweight after 5 and 10 years (+ 2.7% and + 4.5%, respectively) that were midway between those for the child and parent and nonspecific groups and not significantly different from either. At 10 years, child height was related strongly to the height of the parent of the same sex (r = .78 children were 1.8 cm taller than their parents, with no differences in height between groups.