Twelve-Month Effectiveness of a Parent-led, Family-Focused Weight-Management Program for Prepubertal Children: A Randomized, Controlled Trial

Golley, Rebecca K.; Magarey, Anthea; Baur, Louise A.; Steinbeck, Katharine; Daniels, Lynne

doi:10.1542/peds.2006-1746

Cited by 212 publications

(245 citation statements)

References 29 publications

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“…The interventions to treat obesity could broadly be categorized into three groups: interventions aimed at modifying behaviour, diet and/or physical activity delivered to groups of children and/or parents 24,26,29,31,33 or delivered to individual families; 25,27,30 and technology-based interventions used in the home or community aimed at promoting physical activity or reducing sedentary activities. 28,32 For the group-based interventions, planned contact time with professionals ranged from 10 (ref.…”

Section: Resultsmentioning

confidence: 99%

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Economic evaluation of lifestyle interventions to treat overweight or obesity in children

et al. 2012

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OBJECTIVE:To estimate lifetime cost effectiveness of lifestyle interventions to treat overweight and obese children, from the UK National Health Service perspective. DESIGN: An adaptation of the National Heart Forum economic model to predict lifetime health service costs and outcomes of lifestyle interventions on obesity-related diseases. SETTING: Hospital or community-based weight-management programmes. POPULATION: Hypothetical cohorts of overweight or obese children based on body mass data from the National Child Measurement Programme. INTERVENTIONS: Lifestyle interventions that have been compared with no or minimal intervention in randomized controlled trials (RCTs). MAIN OUTCOME MEASURES: Reduction in body mass index (BMI) standard deviation score (SDS), intervention resources/costs, lifetime treatment costs, obesity-related diseases and cost per life year gained. RESULTS: Ten RCTs were identified by our search strategy. The median effect of interventions versus control from these 10 RCTs was a difference in BMI SDS of À0.13 at 12 months, but the range in effects among interventions was broad (0.04 to À0.60). Indicative costs per child of these interventions ranged from d108 to d662. For obese children aged 10 --11 years, an intervention that resulted in a median reduction in BMI SDS at 12 months at a moderate cost of d400 increased life expectancy by 0.19 years and intervention costs were offset by subsequent undiscounted savings in treatment costs (net saving of d110 per child), though this saving did not emerge until the sixth or seventh decade of life. The discounted cost per life year gained was d13 589. Results were broadly similar for interventions aimed at children aged 4 --5 years and which targeted both obese and overweight children. For more costly interventions, savings were less likely. CONCLUSION: Interventions to treat childhood obesity are potentially cost effective although cost savings and health benefits may not appear until the sixth or seventh decade of life.

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Section: Resultsmentioning

confidence: 99%

“…28,32 For the group-based interventions, planned contact time with professionals ranged from 10 (ref. 24) to 128 (ref. 29) hours delivered over periods ranging from 5 --12 months to groups of between 7 and 14 children and/or families.…”

Section: Resultsmentioning

confidence: 99%

Economic evaluation of lifestyle interventions to treat overweight or obesity in children

et al. 2012

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“…4 Typically, obesity interventions in children include treatment-seeking families or recruit via advertisement or referrals. [11][12][13][14][15] The widespread inability of both parents 16 and health professionals 17 to correctly identify children as overweight limits intervention to the very overweight. This seems sensible given that obese children have greater health risks and are more likely to be obese adults than mildly overweight children.…”

Section: What This Study Addsmentioning

confidence: 99%

A Tailored Family-Based Obesity Intervention: A Randomized Trial

Taylor¹,

et al. 2015

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OBJECTIVE: To determine whether a 2-year family-based intervention using frequent contact and limited expert involvement was effective in reducing excessive weight compared with usual care.METHODS: Two hundred and six overweight and obese (BMI $85th percentile) children aged 4 to 8 years were randomized to usual care (UC) or tailored package (TP) sessions at university research rooms. UC families received personalized feedback and generalized advice regarding healthy lifestyles at baseline and 6 months. TP families attended a single multidisciplinary session to develop specific goals suitable for each family, then met with a mentor each month for 12 months, and every third month for another 12 months to discuss progress and provide support. Outcome measurements (anthropometry, questionnaires, dietary intake, accelerometry) were obtained at 0, 12, and 24 months.RESULTS: BMI at 24 months was significantly lower in TP compared with UC children (difference, 95% confidence interval: -0.34, -0.65 to -0.02), as was BMI z score (-0.12, -0.20 to -0.04) and waist circumference (-1.5, -2.5 to -0.5 cm). TP children consumed more fruit and vegetables (P = .038) and fewer noncore foods (P = .020) than UC children, and fewer noncore foods were available in the home (P = .002). TP children were also more physically active (P = .035). No differences in parental feeding practices, parenting, quality of life, child sleep, or behavior were observed.CONCLUSIONS: Frequent, low-dose support was effective for reducing excessive weight in predominantly mild to moderately overweight children over a 2-year period. Such initiatives could feasibly be incorporated into primary care.

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“…This approach emphasizes the importance of parental modeling and authority over the home environment (Golan & Weizman, 2001), as well as engaging the parents as agents of change (Apter, Fainaru, Golan, & Weizman, 1998). Parent-only approaches have been tested in 14 trials included in this review (Apter et al, 1998;Bean, Wilson, Thornton, Kelly, & Mazzeo, 2012;Collins et al, 2011;Golan & Crow, 2004;Golan, Kaufman, & Shahar, 2006;Golley, Magarey, Baur, Steinbeck, & Daniels, 2007;Janicke et al, 2008;Jansen, Mulkens, & Jansen, 2011;Magarey et al, 2011;Mazzeo et al, 2014;Moens & Braet, 2012;Morgan et al, 2014;Munsch et al, 2008;Okely et al, 2010;Shelton et al, 2007). In two trials, Golan and colleagues found FBT with parents as the agents of change more effective than FBT with children as the agents of change for both children (Golan et al, 2006) and adolescents (Apter et al, 1998), with the parentfocused treatment remaining superior at 7-year follow-up (Golan & Crow, 2004), although it should be noted that this study was conducted within a different region and culture (Israel with two-parent families).…”

Section: Parent-only Behavioral Treatmentmentioning

confidence: 99%

Evidence Update on the Treatment of Overweight and Obesity in Children and Adolescents

Altman

Wilfley²

2014

Journal of Clinical Child & Adolescent Psychology

140

149

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Childhood obesity is associated with increased medical and psychosocial consequences and mortality and effective interventions are urgently needed. Effective interventions are urgently needed. This article reviews the evidence for psychological treatments of overweight and obesity in child and adolescent populations. Studies were identified through searches of online databases and reference sections of relevant review articles and metaanalyses. Treatment efficacy was assessed using established criteria, and treatments were categorized as well-established, probably efficacious, possibly efficacious, experimental, or of questionable efficacy. Well-established treatments included family-based behavioral treatment (FBT) and Parent-Only Behavioral Treatment for children. Possibly efficacious treatments include Parent-Only Behavioral Treatment for adolescents, FBT-Guided SelfHelp for children, and Behavioral Weight Loss treatment with family involvement for toddlers, children, and adolescents. Appetite awareness training and regulation of cues treatments are considered experimental. No treatments are considered probably efficacious, or of questionable efficacy. All treatments considered efficacious are multicomponent interventions that include dietary and physical activity modifications and utilize behavioral strategies. Treatment is optimized if family members are specifically targeted in treatment. Research supports the use of multicomponent lifestyle interventions, with FBT and Parent-Only Behavioral Treatment being the most widely supported treatment types. Additional research is needed to test a stepped care model for treatment and to establish the ideal dosage (i.e., number and length of sessions), duration, and intensity of treatments for long-term sustainability of healthy weight management. To improve access to care, the optimal methods to enhance the scalability and implementability of treatments into community and clinical settings need to be established.

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Twelve-Month Effectiveness of a Parent-led, Family-Focused Weight-Management Program for Prepubertal Children: A Randomized, Controlled Trial

Abstract: Parenting-skills training combined with promoting a healthy family lifestyle may be an effective approach to weight management in prepubertal children, particularly boys. Future studies should be powered to allow gender subanalysis.

Cited by 212 publications

References 29 publications

Economic evaluation of lifestyle interventions to treat overweight or obesity in children

Economic evaluation of lifestyle interventions to treat overweight or obesity in children

A Tailored Family-Based Obesity Intervention: A Randomized Trial

Evidence Update on the Treatment of Overweight and Obesity in Children and Adolescents

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