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Guided Self-Help for Pediatric Obesity in Primary Care: A Randomized Clinical Trial

Kyung E Rhee1, Lourdes Herrera2, David Strong3

  • 1Departments of Pediatrics.

Pediatrics
|June 17, 2022
PubMed

Insights

A guided self-help (GSH) obesity treatment model showed higher attendance rates compared to traditional family-based treatment (FBT). While both models reduced child BMI z-score, GSH offers a promising, less intensive option for primary care settings.

Area of Science:

  • Pediatrics
  • Public Health
  • Behavioral Medicine

Background:

  • Childhood obesity is a significant public health concern requiring effective treatment strategies.
  • Traditional family-based behavioral treatment (FBT) is effective but often resource-intensive and delivered in specialized centers.
  • Primary care settings offer greater accessibility for implementing obesity interventions.

Purpose of the Study:

  • To compare the effectiveness of a less intense guided self-help (GSH) program with traditional family-based behavioral treatment (FBT) for childhood obesity.
  • To evaluate differences in treatment attendance and child weight status between the two models.
  • To assess the feasibility of delivering obesity treatment in a primary care setting.

Main Methods:

  • A randomized clinical trial involving 164 children (5-13 years) with BMI ≥85th percentile.
  • Intervention group received 14 individual GSH sessions (5.3 hours) in primary care.
  • Control group received 20 group-based FBT sessions (20 hours) in an academic center.
  • Outcomes included session attendance, change in BMI z-score (BMIz), and percentage from the 95th BMI percentile at post-treatment and 6-month follow-up.

Main Results:

  • The guided self-help (GSH) group had significantly higher attendance rates (odds ratio = 2.2, P < 0.01) and a 67% reduced risk of attrition compared to FBT.
  • No significant between-group differences were observed in the change of BMI z-score or percentage from the 95th BMI percentile over time.
  • A significant reduction in BMI z-score was observed from baseline to post-treatment across both groups (d: 0.60).

Conclusions:

  • A less intense guided self-help (GSH) model demonstrates superior attendance and reduced attrition, supporting its implementation in primary care.
  • GSH offers a viable, accessible alternative for childhood obesity treatment, potentially increasing patient reach.
  • Future research should focus on disseminating and implementing GSH models across diverse settings to broaden access to care.
Abstract

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