Parent-Child Sex Composition Impacts Long-Term Outcomes in Family-Based Behavioural Treatment

Area of Science:

• Pediatric obesity treatment
• Family dynamics in health interventions
• Behavioral therapy research

Background:

• Previous studies indicated opposite-sex parent-child dyads had better weight outcomes than same-sex dyads, but lacked statistical power.
• This study aimed to confirm and expand these findings using a larger dataset.

Purpose of the Study:

• To investigate if parent-child dyad sex composition predicts changes in zBMI and clinically significant weight loss.
• To analyze treatment outcomes at a two-year follow-up.

Main Methods:

• Mega-analysis of individual participant data from 9 randomized Family-Based Behavioural Treatment (FBT) trials (1981-2013).
• Weight outcomes were assessed at 6, 12, and 24 months.
• Clinically meaningful change was defined as a ≥0.25 reduction in child zBMI and ≥5% parent weight loss.

Main Results:

• Children in opposite-sex dyads exhibited greater zBMI reductions and higher odds of achieving clinically meaningful weight loss over two years.
• Parents in opposite-sex dyads did not show significant differences in weight loss.
• Among specific dyads, daughters in mother-daughter pairs had the lowest odds for meaningful weight reduction, while daughters in father-daughter pairs had the highest.

Conclusions:

• Parent-child sex composition significantly impacts children's long-term response to FBT.
• Opposite-sex dyads, particularly father-daughter pairs, demonstrate more enduring benefits in pediatric weight management.
• Dyad composition should be considered in FBT administration to potentially enhance treatment effectiveness.