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Updated: Aug 22, 2025
Multidisciplinary Approach to Obesity Management: A Case Report
Published on: May 30, 2025
Design of the FRESH-DOSE study: A randomized controlled noninferiority trial evaluating a guided self-help
Kerri N Boutelle1, Kyung E Rhee2, Michael A Manzano3
1Department of Pediatrics, University of California San Diego, 9500 Gilman Drive, La Jolla, CA 92093, USA; Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, 9500 Gilman Drive, La Jolla, CA 92093, USA; Department of Psychiatry, University of California San Diego, 9500 Gilman Drive, La Jolla, CA 92093, USA.
Insights
A new guided self-help version of Family-Based Behavioral Treatment (gshFBT) offers a promising, accessible approach to childhood obesity management. This intervention could significantly improve reach for effective weight management strategies in children.
Area of Science:
- Pediatric Endocrinology
- Public Health
- Behavioral Science
Background:
- Childhood obesity affects 45% of children, increasing risks for negative health outcomes.
- Family-Based Behavioral Treatment (FBT) is effective but resource-intensive.
- Guided Self-Help (GSH) therapies offer a scalable alternative by combining manuals with coaching.
Purpose of the Study:
- To evaluate the efficacy and cost-effectiveness of a novel Guided Self-Help version of Family-Based Behavioral Treatment (gshFBT) for pediatric weight management.
- To compare gshFBT with traditional group-based FBT in a randomized controlled trial.
- To assess long-term outcomes of gshFBT for child weight change (BMIz).
Main Methods:
- A randomized controlled trial involving 150 children (mean age 10.1 years, mean BMI% 97.3%) and one parent.
- Participants were assigned to either group-based FBT or gshFBT (manual + 14 coaching sessions over 6 months).
- Assessments included baseline, post-treatment (6 months), and follow-ups at 12 and 18 months, focusing on child BMIz and cost-effectiveness.
Main Results:
- Recruitment completed between May 2017 and October 2021.
- Follow-up assessments are ongoing, with primary outcomes being child weight change (BMIz) and cost-effectiveness.
- The study is poised to provide crucial data on gshFBT's effectiveness and accessibility.
Conclusions:
- gshFBT presents a potentially scalable and accessible intervention for childhood obesity.
- This approach may overcome barriers associated with traditional, resource-intensive FBT programs.
- gshFBT could significantly expand access to effective pediatric weight management interventions.
Abstract:
Overweight and obesity affect 45% of children and increases the risk for several negative health sequelae. Family-Based Behavioral Treatment (FBT) is the most efficacious treatment for child weight management and consists of nutrition and physical activity education, behavior change skills and parenting skills training. FBT is time and staff intensive and can include 20, 60-min separate groups for parents and children, as well as 20-min behavior coaching sessions to help problem solve barriers to implementing the skills learned and individualize the program. Guided self-help (GSH) therapies involve providing families a manual to review independently and brief coaching sessions by an interventionist to facilitate adherence. We developed a GSH version of FBT (gshFBT) which provides a manual to both parents and children and includes 14, 20-min coaching sessions over 6-months. The current study randomized 150 children (mean age = 10.1 years (SD = 1.38); mean BMI% = 97.3% (SD = 2.84); mean BMIz = 2.09 (SD = 0.40); 49% female; 43% Hispanic) and one of their parents (mean age = 41.8 years (SD = 6.52); mean BMI = 32.0 (SD = 7.24); 87.3% female; 43% Hispanic) to either a group-based FBT program or a gshFBT program. Assessments are conducted at baseline, post-treatment (6 months), 6-month follow-up (12 months) and 12-month follow-up (18 months). Primary outcomes are child weight change (BMIz) and cost effectiveness. Recruitment occurred between May 2017 and October 2021 and follow-up assessments are underway. Given the public health concern for children with obesity and the low level of access to FBT, gshFBT could prove extremely useful to provide intervention to a greater proportion of the population.
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