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Do Children Need to be Present in Obesity Treatment?

JAMA Pediatr; ePub 2017 May 30; Boutelle, et al

Publish date:

In treatment for child weight loss, parent-based treatment (parent-only) was as effective as family-based treatment (parent and child) on child weight loss over 24 months, according to a recent study. The randomized 2-arm noninferiority trial was held between July 2011 and July 2015 and included 150 overweight and obese 8- to 12-year-old children and their parents. Both parent-based treatment (PBT) and family-based treatment (FBT) were delivered in 20 1-hour group meetings with 30-minute individualized behavioral coaching sessions over 6 months. Primary outcome measure was child weight loss at 6, 12, and 18 months post-treatment. Secondary outcomes were parent weight loss, child and parent energy intake, parent and child physical activity, parenting style, and parent feeding behaviors. Researchers found:

  • 155 children and their parent were randomly assigned to either FBT or PBT.
  • Child weight loss after 6 months was -0.25 BMI z scores in both PBT and FBT.
  • Intention-to-treat analysis showed that PBT was noninferior to FBT on all outcomes at 6, 12, and 18 months follow-up with a mean difference in child weight loss of 0.001.

Citation:

Boutelle KN, Rhee KE, Liang J, et al. Effect of attendance of the child on body weight, energy intake, and physical activity in childhood obesity treatment. A randomized clinical trial. [Published online ahead of print May 30, 2017]. JAMA Pediatr. doi:10.1001/jamapediatrics.2017.0651.

Commentary:

One-third of children in the US are currently overweight or obese,1 making understanding what types of behavioral interventions might work a critical issue. This study addresses a practical hurdle for many families, which is the ability to schedule both parents and children at the same time for education on how to implement dietary and exercise changes in their lives. This study essentially shows that programs directed to parents work equally well as those directed to both parents and children. —Neil Skolnik, MD

  1. Ogden CL, Carroll MD, Kit BK, Flegal KM. Prevalence of childhood and adult obesity in the United States, 2011-2012. JAMA. 2014;311(8):806-814. doi:10.1001/jama.2014.732.

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