Ten-year follow-up of behavioral, family-based treatment for obese children

Article Abstract:

Parental obesity is the most important risk factor in childhood obesity; thus, the problem of an obese child involves the family. Treatment approaches that make use of this fact focus on both parents and children, and research using such methods has shown that effects can last as long as five years. The current randomized study compares three approaches to treating childhood obesity in subjects followed-up for 10 years. Seventy-six children and their parents were randomly assigned to one of the following treatment groups: group 1, where child and parent weight loss and behavioral change were the goals; group 2, where only the child's weight loss and behavioral change were goals; and group 3, where no specific target was set. The ''traffic light diet'' (a color-coded system) was used for weight loss, and behavioral approaches included contracting (making rewards contingent on weight loss), self-monitoring, and social reinforcement and modeling. The program began with eight weekly treatment sessions and continued for six more monthly meetings. Follow-up was carried out at 21, 60 and 120 months. Results showed that the children in group 1 decreased the amount they were overweight, while those in the other two groups increased their amounts overweight. Children in groups 2 and 3 were eventually significantly heavier than those in group 1. Heights of all children after 10 years' growth were equivalent, indicating that the program produced no generally negative effect on health. No group differences for parental overweight were found after 10 years; although parents in all the groups became less overweight by the time treatment ended, they had returned to their baseline percent overweight by 10 years' follow-up. The findings support the possibility that children between the ages of 6 and 12 can be treated for obesity with a behavioral, family-based approach. A discussion is presented of the reasons this approach may have been effective. Methods need to be developed that would promote still greater weight loss, however. (Consumer Summary produced by Reliance Medical Information, Inc.)

Psychological aspects, Behavior, Overweight persons, Family, Family health

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Growth in obese children treated for obesity

Article Abstract:

There are many benefits achieved by successful treatment of obesity in children, including the short-term improvement in physical fitness and blood pressure and long-term prevention of adult obesity and related diseases such as heart disease and diabetes. A possible negative aspect of weight reduction in children is its potential effect on growth. In evaluating this effect, two factors about a child's height need to be considered: first, obese children are overnourished and tend to be taller than nonobese children; and second, the height of the child's parents must be considered. A study was undertaken to assess the growth patterns of children aged 6 to 12 who were treated for obesity. Their growth was followed-up for five years. The results showed that initially, the obese children were taller than their nonobese peers (75th percentile in height versus an average of the 50th percentile), and that they continued to be taller (65th percentile) after five years. It was found that when changes in height percentile are adjusted for parental height, there are two variables that are predictive of change: initial height percentile and parental height. Change in weight did not correlate with growth when adjusted for parental height. These results suggest that weight control in children of this age does not have an adverse effect on height, as observed after five years of follow-up. (Consumer Summary produced by Reliance Medical Information, Inc.)

Complications and side effects, Stature, Body height

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Efficacy of maintenance treatment approaches for childhood overweight: a randomized controlled trial

Article Abstract:

A study explores the short- and long-term efficacy of two distinct weight maintenance approaches versus no continued treatment control following standard family-based behavioral weight loss treatment for childhood overweight, and examines children's social functioning as a moderator of outcome. Results indicate that the addition of maintenance-targeted treatment improves short-term efficacy of weight loss treatment for children relative to no maintenance treatment.

Clinical report

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