Camp-based family treatment of childhood obesity: randomised controlled trial

Abstract

ObjectiveTo compare the effectiveness of a 2-year camp-based family treatment programme and an outpatient programme on obesity in two generations.DesignPragmatic randomised controlled trial.SettingRehabilitation clinic, tertiary care hospital and primary care.PatientsFamilies with at least one child (7–12 years) and one parent with obesity.InterventionsSummer camp for 2 weeks and 4 repetition weekends or lifestyle school including 4 days family education. Behavioural techniques motivating participants to healthier lifestyle.Main outcome measuresChildren: 2-year changes in body mass index (BMI) SD score (SDS). Parents: 2-year change in BMI. Main analyses: linear mixed models.ResultsNinety children (50% girls) were included. Baseline mean (SD) age was 9.7 (1.2) years, BMI 28.7 (3.9) kg/m2 and BMI SDS 3.46 (0.75). The summer-camp children had a lower adjusted estimated mean (95% CI) increase in BMI (−0.8 (−3.5 to −0.2) kg/m2), but the BMI SDS reductions did not differ significantly (−0.11 (−0.49 to 0.05)). The 2-year baseline adjusted BMI and BMI SDS did not differ significantly between summer-camp and lifestyle-school completers, BMI 29.8 (29.1 to 30.6) vs 30.7 (29.8 to 31.6) kg/m2 and BMI SDS 2.96 (2.85 to 3.08) vs 3.11 (2.97 to 3.24), respectively. The summer-camp parents had a small reduction in BMI (−0.9 (−1.8 to −0.03) vs −0.8 (−2.1 to 0.4) in the lifestyle-school group), but the within-group changes did not differ significantly (0.3 (−1.7 to 2.2)).ConclusionsA 2-year family camp-based obesity treatment programme had no significant effect on BMI SDS in children with severe obesity compared with an outpatient family-based treatment programme.Trial registration numberNCT01110096.

Intervention differential effects and regression to the mean in studies where sample selection is based on the initial value of the outcome variable: an evaluation of methods illustrated in weight-management studies

“…For example, in Janicke et al 's [18] systematic review of randomised controlled trials, they excluded 54 of 278 papers selected for full-text review because they lacked appropriate control groups. Likewise, Benestad et al's [19] study noted a similar lack of adequate control groups in observational (i.e. non-experimental) weight-loss studies.…”

Health-related quality of life after camp-based family obesity treatment: an RCT

“…Data collection occurred between April 2010 and June 2013. Details of the trial have been published previously 12…”

“…Previously, we reported results of a 2-year randomised controlled trial (RCT) of a family summer camp treatment compared with an outpatient lifestyle intervention, finding no significant between-group differences after 2 years for primary outcomes (age-adjusted and sex-adjusted body mass index [BMI] SD score [BMI-SDS] for children’s and parents’ BMI) 12. However, these treatment options may still affect HRQoL differently.…”

Teenage Girlhood and Bodily Agency: On Power, Weight, Dys-Appearance and Eu-Appearance in a Norwegian Lifestyle Programme

“…However, despite the substantial efforts invested, the results of lifestyle programmes for young people have often been disappointing. A literature review suggests that, in many cases, participants register little change in their BMI by the end of the course (Benestad et al, 2016;Elvsaas, Juvet, Giske, & Fure, 2016;Ochner, Barrios, Lee, & Pi-Sunyer, 2013). A very similar pattern emerges in respect of lifestyle programmes targeting adults: whether in terms of participants reducing their BMI or managing to sustain such reductions in the long term, results have proved modest or negligible (Garner & Wooley, 1991;Ochner et al, 2013).…”

“…The emphasis in this regard has been on family-oriented lifestyle interventions rather than childonly ones, in the expectation that targeting parents along with the child will serve to enhance treatment effectiveness. However, this assumption has been called into question by a recent randomized controlled trial comparing the results from a camp-based programme for families with those of an out-patient family-oriented treatment programme (Benestad et al, 2016). Benestad and colleagues found that the camp-based programme had "only small long-term effects on BMI (and some cardiovascular risk factors) in children with severe obesity", that "most children remained obese after treatment", and that it therefore seemed "unlikely that the high summer camp costs can be justified given the modest effects" (Benestad et al, 2016, p. 7).…”