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Parenting Training Plus Behavioral Treatment for Children With Obesity: A Randomized Clinical Trial.
Kyung E Rhee1, Takisha Corbett1, Shamin Patel1
1Department of Pediatrics, University of California, San Diego School of Medicine, La Jolla.
JAMA Network Open
|May 5, 2025
Summary
Intensive parenting training (PT) added to family-based behavioral treatment (FBT) did not significantly change child obesity metrics. However, more children receiving FBT plus PT achieved clinically meaningful weight loss compared to FBT alone.
Area of Science:
- Pediatric obesity treatment
- Behavioral health interventions
- Family-centered care
Background:
- Family-based behavioral treatment (FBT) is a standard for childhood obesity but not universally effective.
- Parenting training (PT) is linked to improved weight and eating behaviors in children.
- Intensive PT may enhance FBT by improving behavior change strategies and child weight loss.
Purpose of the Study:
- To compare the effectiveness of adding intensive PT to standard FBT versus FBT alone for treating childhood overweight and obesity.
Main Methods:
- A 2-arm randomized clinical trial (ReFRESH) involved 140 children (7-12 years) with overweight/obesity and a parent.
- Participants were randomized to FBT plus PT or FBT alone, receiving 20 sessions over 6 months.
- Primary outcomes included changes in BMI z-score and BMI percentile; secondary outcomes were clinically meaningful weight loss and dropout rates.
Main Results:
- No significant differences in BMI z-score or BMI percentile were found between the FBT plus PT and FBT alone groups at 6 or 12 months.
- Both groups showed significant reductions in weight status.
- A higher proportion of children in the FBT plus PT group achieved clinically meaningful weight loss (48.6% vs. 31.4%).
Conclusions:
- While adding intensive PT to FBT did not significantly alter overall weight status metrics, it increased the likelihood of achieving clinically meaningful weight loss in children.
- Both treatment approaches were well-accepted with similar dropout rates.
- Further research is needed to identify factors influencing treatment response and parenting skill changes.
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