Racial and socioeconomic disparities in the efficacy of a family‐based treatment programme for paediatric obesity

Abstract

Background: Family-based behavioural weight loss treatment (FBT) is an evidencebased intervention for paediatric overweight/obesity (OV/OB), but little research has examined the relative efficacy of FBT across socioeconomic status (SES), and racial groups.Method: A total of 172 youth (7-11 years; 61.6% female; 70.1% White, 15.7% Black; child percent OV = 64.2 ± 25.2; 14.5% low-income) completed 4 months of FBT and 8 months of additional intervention (either active social facilitation-based weight management or an education control condition). Parents reported family income, social status (Barratt simplified measure of social status) and child race at baseline. Household income was dichotomized into < or >50% of the area median family income. Race was classified into White, Black or other/multi-race. Treatment efficacy was assessed by change in child % OV (BMI % above median BMI for age and sex) and change in child BMI % of 95th percentile (BMI % of the 95th percentile of weight for age and sex). Latent change score models examined differences in weight change between 0 and 4 months, 4 and 12 months and 0 and 12 months by income, social status and race.Results: Black children had, on average, less weight loss by 4 months compared to White children. Low-income was associated with less weight loss at 4 months when assessed independent of race. No differences by race, social status or income were detected from 4 to 12-months or from 0 to 12 months. Conclusions:FBT is effective at producing child weight loss across different SES and racial groups, but more work is needed to understand observed differences in initial efficacy and optimize treatment across all groups.

Attenuated efficacy of pediatric obesity treatment during the COVID‐19 pandemic

“…Given its timeline, the parent trial was uniquely positioned to examine changes in pediatric obesity treatment efficacy following the COVID‐19 lockdown. The study focused on low‐income children aged 6 to 12 who were predominantly of a racial minority, a group with a high burden of pediatric obesity (17) and poorer engagement and outcomes in weight‐management interventions (18,19). However, findings may not generalize to other populations, and the sample’s composition did not enable comparisons with higher‐socioeconomic status or nonminority children.…”

A Risk Profile for Disordered Eating Behaviors in Adolescents with Type 1 Diabetes: A Latent Class Analysis Study

“…The classification of professions of the Italian Institute of Statistics (ISTAT) [ 24 ] was used to classify parents’ occupations according to nine major groups; occupational categories were considered in two skill levels: high (Manager, Legislators, Chief Executives Officials, Technicians and Associate Professionals, Science, Engineering, Health, Teaching, Business and Administration, Information and Communications Technology, Legal, Social, Cultural Professionals, and Armed Forces Officers) and low (Elementary Occupations, Clerical Support Workers, Services and Sales Workers, Skilled Agricultural, Forestry and Fishery Workers, Craft and Related Trades Workers, Armed Forces Occupations, and Other Ranks). These data were summarized and scored using the Barratt Simplified Measure of Social Status (BSMSS) [ 25 ]. Parental familiarity with T1D and type 2 diabetes (T2D) was also investigated.…”

Childhood obesity and racism: 2022 views and observations

“…A responsibility to investigate and rectify any race based influences past and present in this regard is indeed incumbent upon all who can make a difference. 27 As per Shepard et al, 21 and others, 46,47 a host of possible direct and persistent vicarious impacts of racial discrimination and multiple racist based social biases appear to persist and are potentially sufficiently pervasive to foster highly detrimental impacts to the physical and mental health of minority children to a greater extent than mainstream youth. 48 The early, as well as the more frequent exposure to racial discrimination related impacts, if not mitigated or eliminated will predictably impact on multiple domains of health in later life, especially those related to weight status and a host of associated chronic health conditions.…”