An Intensive Family Intervention Clinic for Reducing Childhood Obesity

Abstract

Background: Childhood and adolescent obesity constitute a significant public health concern. Family health care settings with multidisciplinary teams provide an opportunity for weight loss treatment. The objective of this study was to examine the effect of intensive treatment designed to reduce weight using a parent-child lifestyle modification intervention in a family health care clinic for obese and overweight children who had failed previous treatment attempts.Methods: This was a practice-based 6-month intervention at Maccabi Health Care Services, an Israeli health maintenance organization, consisting of parental education, individual child consultation, and physical activity classes. We included in the intervention 100 obese or overweight children aged 5 to 14 years and their parents and 943 comparison children and their parents. Changes in body mass index z-scores, adjusted for socioeconomic status, were analyzed, with a follow-up at 14 months and a delayed follow-up at an average of 46.7 months.Results: The mean z-score after the intervention was lower in the intervention group compared to the comparison group (1.74 and 1.95, respectively; P ‫؍‬ .019). The intervention group sustained the reduction in z-score after an average of 46.7 months (P < .001). Of the overweight or obese children, 13% became normal weight after the intervention, compared with 4% of the comparison children.

Effectiveness of educational and lifestyle interventions to prevent paediatric obesity: systematic review and meta-analyses of randomized and non-randomized controlled trials

“…Based on the pertinence of the abstract, 1,524 of them were excluded; the remaining 190 were read in extenso . Thirty‐five of them were considered pertinent (1 non‐randomized trial and 34 randomized controlled trial [RCT]) and were thus included in the meta‐analyses, together with the 37 studies (31 RCT and 6 non‐randomized trial) already included in Waters et al . meta‐analysis .…”

Challenges and Successes of a Multidisciplinary Pediatric Obesity Treatment Program

“…Members of a multidisciplinary team include the medical provider, RDN, exercise specialist, mental health professional, nurse, and administrative support. Multidisciplinary clinics designed to meet stages 3 and 4 are well supported by the literature in their effectiveness to reduce body mass index (BMI) and reduce the risk of future comorbidities 5 – 11 . Programs are becoming more common around the country, but in many areas, especially rural areas and those without a children's hospital, sufficient resources do not exist 12 .…”

Consequences and Prevention of Childhood Obesity

“…• Developing strategies to scientifically evaluate the eating behavior of children -to achieve this research can be performed in heterogeneous settings under professionals guidance so that results of these studies can be utilized while formulating the future welfare policies intended to reduce the prevalence of childhood obesity; • Starting an intensive clinic for reducing prevalence of childhood obesity -this initiative can be started initially (under the guidance of a pediatrician, child psychologist, school teacher, nutritionist, etc. ), in an area with high prevalence of childhood obesity and based on the results obtained, initiative can be expanded further; and • Ensuring availability of only nutritional rich foods within the premises of school -schools can set an example by providing nutritious foods and thus can serve as a benchmark for the families of the children to motivate their kids to consume similar kinds of meals even at home [10,11,15,16].…”