Who Benefited Most? Identifying Parent-Child Dyads With Improved Weight Outcomes in the Feel4Diabetes Study

Family-based interventions offer a promising solution to the pressing global health concern of childhood obesity by addressing the interconnected behaviours of parents and children. Nevertheless, limited evidence identifies which families benefit most when outcomes are evaluated at the parent-child dyad level.

To identify which parent-child dyads experienced clinically meaningful improvements in weight status over 1- and 2-year periods within the Feel4Diabetes study, a school- and community-based intervention targeting European families at risk for Type 2 diabetes.

Data were drawn from 2402 high-risk families across six European countries. For participants with overweight/obesity, improvement meant ≥ 5% parental weight loss and a ≥ 0.15-unit child BMI-z reduction. Multiple logistic regression models identified socio-demographic and contextual predictors of dyadic improvement.

After 2 years, 5.3% of families achieved improvements in both parent and child. Significant predictors of dyadic success included intervention group participation [OR = 2.56 (95% CI: 1.31-5.03)] and residing in high-income countries under austerity measures [OR = 2.44 (1.00-6.02)]. Girls were more likely to improve than boys, while full-time maternal employment was associated with lower odds of dyadic improvement.

Sustained benefits were observed in a subset of families, highlighting the need for tailored, context-sensitive family-centred obesity prevention strategies.