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A randomised study on the effectiveness of therapist-led v. self-help parental intervention for treating childhood
Hilde Tang Hystad1, Silje Steinsbekk, Rønnaug Ødegård
1Institute of Medicine, Haukeland University Hospital, University of Bergen, N-5021 Bergen, Norway.
Insights
Both therapist-led groups (TLG) and self-help groups (SHG) for parents effectively reduced childhood obesity, adiposity, and improved dietary intake long-term. These interventions showed equal effectiveness in treating pediatric obesity.
Area of Science:
- Pediatric Endocrinology
- Public Health Nutrition
- Behavioral Medicine
Background:
- Childhood obesity is a growing concern requiring cost-effective treatment strategies.
- Limited resources necessitate efficient interventions for pediatric obesity management.
- Parental involvement is crucial for successful long-term outcomes in childhood obesity treatment.
Purpose of the Study:
- To compare the long-term effectiveness of therapist-led groups (TLG) versus self-help groups (SHG) for parents in managing childhood obesity.
- To evaluate changes in children's adiposity and dietary intake following TLG and SHG interventions.
- To assess the sustainability of treatment effects over 24 months.
Main Methods:
- A randomized controlled trial involving 99 children (7–12 years) with obesity (BMI z-score ≥ 2).
- Parents were randomized to either TLG (n=47) or SHG (n=52) for 15 sessions, focusing on lifestyle changes.
- All families received individual counseling from a dietitian and physiotherapist; children attended separate groups. Adiposity (BF%, BMI z-score) and dietary intake were measured at baseline, 6, and 24 months.
Main Results:
- No significant differences in adiposity or dietary intake changes between TLG and SHG groups at 6 and 24 months.
- Both groups showed significant reductions in body fat (BF), BMI z-scores, and energy intake by 6 months, sustained at 24 months.
- Improvements were achieved without adverse effects on diet macronutrient composition.
Conclusions:
- Therapist-led groups and self-help groups demonstrate comparable long-term effectiveness in treating childhood obesity.
- Both intervention types successfully improved pediatric adiposity and dietary habits.
- Self-help groups may be a resource-efficient alternative for parental obesity treatment in children, warranting further investigation.
Abstract:
A strategy is needed on how to treat the growing number of obese children with the limited resources available. We compared the long-term (24 months) effectiveness of therapist-led groups (TLG) v. self-help groups (SHG) for parents on changes in children's adiposity and dietary intake. The study included ninety-nine children (forty-eight girls) who were referred to obesity treatment (7–12 years, BMI z-scores ≥ 2, attendance of at least one parent). Parents (ninety-one mothers, fifty-four fathers) were randomised to TLG aimed at increasing parents' competence to accomplish lifestyle changes (n 47), or SHG (n 52), both with fifteen sessions. All children participated in children's groups, and all families attended individual counselling by a clinical dietitian and physiotherapist. Percentage of body fat (BF) was measured by dual-energy X-ray absorptiometry, BMI z-score was calculated by international reference values and dietary intake was calculated from 4 d estimated food records at baseline and after 6 and 24 months. No significant between-group differences were detected in the children's changes in adiposity or dietary intake after 6 and 24 months. BF, BMI z-scores and energy intake were significantly decreased after 6 months (P< 0·05) in both intervention groups, and this persisted throughout 24 months without compromising the diet macronutrient composition. In conclusion, the TLG and SHG intervention groups appear to be equally effective in improving long-term adiposity and dietary intake in obese children. Further research should be performed to clarify whether the SHG should be preferred to parental group treatment for similar children with obesity.
