1. A 12-month weight loss intervention that treated overweight children and their parents concurrently produced greater initial and sustained decreases in the BMI of both parties, as compared to interventions that focused solely on the child.
2. Following completion of the intervention, parents and children in the Intervention group were better able to maintain weight loss than their counterparts in the information control group.
Evidence Rating Level: 2 (Good)
Study Rundown: With close to 23% of 2- to 5-year old children having a BMI above the 85th percentile, there is a growing pressure on the Pediatric community to prevent and treat obesity early so as to prevent their co-morbidities. Evidence suggests that many children with an elevated BMI live with a parent figure that also has an elevated BMI. This study sought to investigate whether or not weight-controlling approaches that jointly target parent and child lead to greater reductions in BMI than traditional approaches focusing on the child alone. Results indicate that the family approach does in fact produce greater positive changes in BMI and weight. The study did not quantify the percent difference in BMI and weight between the Intervention and control group, thus limiting interpretation of the significance of the between-group difference observed. Nonetheless, these results suggest that concurrently targeting children and parents may help to prevent the detrimental effects of early obesity in the child and improve those already present in the obese parent.
Study Author, Dr. Teresa Quattrin, M.D. talks to 2 Minute Medicine: Women and Children’s Hospital of Buffalo, Division of Pediatric Endocrinology.
“This is a new era where students, trainees and specialists have to learn how to better interact with primary care providers and implement care coordination, this project is built on these premises. The traditional approach to overweight prevention and treatment focusing only on the child is obsolete. This paper points to the fact that indeed family based strategies for any chronic disorder, including obesity, can be successful in primary care. The pediatrician’s office can become a ‘family centered medical home’.”
In-Depth (randomized controlled trial): Participants included 2- to 5-year-old children from four Pediatric practices who had a BMI ≥85th percentile and an overweight parent (BMI >0.25 kg/m2). Ninety-six subjects were randomized to the Intervention group, where both parent and child were a target of weight loss and behavior modification, or to the information control (IC) group, where only the child was the focus of interventions. Both groups received 13 60-minute diet and activity education sessions over 12 months, followed by 12-months of follow-up. Children in the Intervention group had significantly greater decreases in weight and %OBMI* from baseline at all time points (P= < .005) compared to the IC group. Similarly, significantly greater weight and BMI reductions were seen in parents in the Intervention group, compared with those in IC (P= .001).
*%OBMI, or percent over BMI, was defined as [(child’s BMI – 50th percentile BMI)/50th percentile BMI] * 100.
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