The effects of a family-based intervention (FBI) for overweight/obese children on health and psychological functioning.

Abstract

Obesity is the most prevalent chronic disease in childhood. There are many comorbidities associated with excess weight that are preventable with improved health. Prevention of medical comorbidities associated with obesity is critical and should begin early, particularly in childhood and preadolescence. This article examined immediate post-treatment and follow-up results of a randomized controlled trial of a 6-month lifestyle intervention involving diet, education, physical exercise, behavior change, and psychosocial methods for overweight or obese school-age children ages 8 to 11 to decrease risk factors associated with medical complications of obesity. Included are outcome data for youth participating in baseline, post-treatment, and 12-month follow-up evaluations. One hundred thirty overweight/obese youth were randomized to a control group or to a 14-session family-based group intervention over 6 months. Medical and psychosocial outcome data were measured at baseline, post-treatment, and follow-up. The intervention group (IG) showed a significant reduction in body mass index z-score (zBMI) and serum triglycerides, particularly for those in the treatment group who attended more sessions of the intervention. The treatment showed significant improvement in zBMI scores at post-treatment, and these results persisted after 12 months. There was no change observed in psychosocial outcome data. Obese children undergoing a family-based intervention (FBI) saw significant improvements in body mass index (BMI) and serum triglycerides that were sustained over 12 months following intervention. Future research should target retention and maintenance in FBIs, with the goal to prevent onset of medical morbidities associated with this disease.

Treatment of overweight and obesity in children and youth: a systematic review and meta-analysis

“…61 Four trials reported follow-up data (6-12 mo postintervention). 32,41,57,60 Meta-analysis showed significantly lower BMI and BMI z-score in the intervention group compared with the control group by the end of treatment (Table 3). However, there was no difference in BMI and BMI z-score between groups at the time of postintervention to 1-year follow-up.…”

“…Eleven interventions involved group sessions, 5 used individual sessions, and almost all interventions (n = 12) incorporated parental or family involvement. 32,35,36,41,48,49,51,[53][54][55]58,60 Three interventions used technology to facilitate interaction between participants and study personnel or as a means of delivering information or encouraging physical activity. Duration of interventions ranged from 3 months to 2 years.…”

Recent Updates on the Efficacy of Group-Based Treatments for Pediatric Obesity

“…Mazzeo et al (2014) utilized a parent-only approach and found that 6 or 12 90-minute sessions (duration was adjusted during treatment) resulted in a loss of 0.28 BMI percentile points in the intervention group, which represented a small but significant decrease in BMI percentile compared to the control group, which did not experience any weight changes ( d =0.11) (34). Lochrie et al (2013) used 14 sessions across a longer time period (6 months) and found a reduction in zBMI of 0.13 in the intervention group, but a negligible loss of 0.03 zBMI points in the control group ( d =0.31) (35). A unique approach by Morgan et al (2013) which primarily targeted fathers’ weight, but had secondary aims to improve child lifestyle behaviors, also was successful in producing significantly improved zBMI weight outcomes (loss of 0.18 points) compared to a wait-list control group (loss of 0.08 points) ( d =0.10) (36).…”

Predictors of Participant Attendance Patterns in a Family-Based Intervention for Overweight and Obese Hispanic Adolescents

“…A recent systematic review of obesity-related randomized controlled trials conducted with Hispanic youth aged 5–19 years old identified 11 interventions published between 2010–2015, the majority of which (72%) included some sort of family-based component [ 13 ]. Although family-based pediatric weight loss studies have been found to successfully reduce youth BMI [ 14 ], stronger effects are often detected in those with higher versus lower rates of attendance [ 15 , 16 , 17 ]. Notably, poor attendance in both clinical and research settings has been cited as one of the most common challenges of pediatric obesity interventions, with the highest rates of attrition observed among low income and ethnic minority populations [ 18 , 19 , 20 , 21 , 22 ].…”