Opinion Statement
Family-based behavioral intervention has been demonstrated to be an effective and safe treatment for childhood obesity and should be considered a first-line treatment option. However, access to such intensive evidence-based treatment is limited and, currently, obesity care is dominated by high intensity behavioral treatment implemented in specialty clinics or less effective, low intensity treatments implemented in primary care. However, capitalizing on the established and ongoing relationship between primary care providers and families, primary care providers hold an invaluable role in early identification of overweight and obesity, and subsequent referral to an evidence-based treatment. key aspects of effective treatment include: early intervention, moderate- to high-intensity intervention of sufficient duration, multi-component intervention targeting dietary modification, physical activity and behavioral strategies, family involvement and goals targeting family members, and follow-up contact during maintenance. The purpose of this review is to present the current empirically supported treatment options for pediatric obesity including primary care-based interventions and diagnostic tools, multi-component behavioral intervention with a focus on family-based behavioral intervention, immersion treatment, and pharmacologic and surgical management.
Background
There is limited research on optimal treatment formats for childhood obesity. Group-based interventions are popular, but it is unclear whether outcomes can be obtained without an additional individual component.
Aim
To examine statistically and clinically significant outcomes of recent group-based and mixed-format (group + Individual) pediatric obesity interventions.
Methods
Effect sizes and magnitudes of weight change were calculated for studies published between January 2013 and September 2014.
Results
Approximately half of the group-based studies reviewed produced significant results compared to control, and effect sizes were small. Mixed-format studies were less likely to include a control group, but those that did evidenced medium to large effects. Magnitudes of weight change post-intervention were generally greater in mixed-format studies than group-only studies.
Conclusions
Recent studies in pediatric obesity interventions suggest including an individual component in a group-based intervention produces optimal outcomes. Future research should directly compare group-only and mixed formats to confirm this observation.
134 0.663METS), and running had a mean error of -0.434METS (SDERROR = 1.16METS).
CONCLUSION:The results of this study indicate that a smartphone can be used as an accelerometer-based PA monitor for treadmill walking and running in healthy adults, providing estimates of PAEE with accuracies similar to those published for other devices. Further development of this technology may improve the research tools used in studies of free-living PA behaviours.
(No relationships reported)PURPOSE: The purpose of this study was to develop a new 2-regression model for relating ActiGraph activity counts to energy expenditure (EE) over a wide range of physical activities (PA) in children.
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