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Multidisciplinary Approach to Obesity Management: A Case Report
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Multidisciplinary Approach to Obesity Management: A Case Report

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Clinically effective child change in family-based behavioral treatment for pediatric obesity: An individual

Leonard H Epstein1, Nicholas V Neuwald1, Rocco A Paluch1

  • 1Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo.

Health Psychology : Official Journal of the Division of Health Psychology, American Psychological Association
|June 11, 2026
PubMed

Insights

Family-based behavioral treatment (FBT) demonstrates significant clinical effectiveness for pediatric obesity, with long-term benefits in body mass index z-score (zBMI) and obesity reversal. Younger children show greater improvements, highlighting FBT

Area of Science:

  • Pediatric Endocrinology
  • Behavioral Health
  • Obesity Medicine

Background:

  • Family-based behavioral treatment (FBT) is an established intervention for childhood overweight and obesity.
  • While statistically significant, the clinical significance of FBT, particularly in relation to cardiometabolic disease prevention, requires further evaluation.
  • Defining clinically meaningful changes in body mass index z-score (zBMI) is crucial for assessing treatment impact.

Purpose of the Study:

  • To evaluate the clinical effectiveness of FBT using a mega-analysis of randomized controlled trials.
  • To determine the percentage of children achieving a clinically significant zBMI reduction (-0.25) and obesity reversal at multiple long-term follow-up points.
  • To investigate age and sex as predictors of treatment response in pediatric obesity.

Main Methods:

  • A mega-analysis of 16 randomized controlled studies involving 1,098 children (aged 6-12) with overweight/obesity and their parents.
  • Individual participant data were analyzed to assess zBMI change and obesity status at 6, 12, 24, 60, and 120 months.
  • Statistical analyses examined the proportion meeting the -0.25 zBMI criterion and obesity reversal, alongside predictor variables like age and sex.

Main Results:

  • A substantial proportion of children met the -0.25 zBMI criteria at all follow-ups: 70% (6 months) to 68% (120 months).
  • Obesity reversal rates increased significantly over time, from 29% at 6 months to 48% at 120 months.
  • Younger age was identified as a reliable predictor of greater zBMI change up to 24 months.

Conclusions:

  • FBT demonstrates sustained clinical effectiveness in pediatric obesity treatment, with outcomes improving or remaining stable long-term.
  • The findings support the clinical utility of FBT, complementing traditional statistical significance reporting.
  • This study provides valuable data on the long-term clinical effectiveness of FBT for childhood obesity.
Abstract

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