A comparison of three behavioral programs for the control of obesity in children

Kingsley, Raymond G.; Shapiro, Joan Rankin

doi:10.1016/s0005-7894(77)80118-4

Cited by 101 publications

(42 citation statements)

References 7 publications

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“…Our results are consistent with previous reports, indicating the importance of a multifaceted behavioural treatment programme in inducing weight loss in children. 27,28 Epstein et al, 29 in their correlation analyses, also suggest that the improvement in the behaviours targeted during treatment, was related to long-term success. Successful outcomes, with a focus on modi®cation of eating habits rather than on dietary restriction, have also been reported by others.…”

Section: Discussionmentioning

confidence: 93%

True

1998

Int J Obes

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OBJECTIVE: This study examined the reduction in overweight and changes in eating-related behaviours in obese children treated with a family-based approach, in which the parents were the exclusive agents of change. Results were compared to the conventional approach in which children are responsible for their own weight loss. DESIGN: A one-year longitudinal prospective design was used. Participants were randomly allocated for the experimental (parents as the agents of change) or the conventional (children as the agents of change) intervention. METHODS: Sixty obese children (20% over ideal weight for age, height and gender) aged 6 ± 11 y (mean AE s.d. 9.2 AE 1.0 y) were included in the study. Anthropometric measurements and biochemical tests were performed on the children and their parents before and after the programme, and both parents completed a sociodemographic and a family eating and activity habits questionnaire. Hour-long supportaeducational sessions were conducted by a clinical dietitian ± 14 sessions for the parents in the experimental intervention and 30 for the children in the conventional intervention. Individual sessions were held for members of both groups, when necessary. RESULTS: Signi®cant differences were found between the two groups in the reduction of exposure to food stimuli and changes in eating habits (eating while standing, watching TV, reading or doing homework, eating following stress and eating between meals). Mean weight reduction (by percentile) was signi®cantly greater in the experimental intervention group (parent-only treatment) in comparison to the conventional intervention group (child-only treatment). CONCLUSIONS: Treatment of childhood obesity with the parents as the exclusive agents of change, induces more behavioural changes as well as greater weight loss, than the conventional approach.

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Section: Discussionmentioning

confidence: 93%

True

1998

Int J Obes

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“…34,[97][98][99][100][101][102][103][104][105][106][107] These investigations varied (by random assignment) whether PACs were treated together with (versus separately from) their obese child or varied whether PACs (versus the youths) were the primary target of intervention. We retrieved trials dating from 1975 108 through 2008 106 that examined whether there were significant differences among treatment groups with respect to improvements in child overweight status after treatment or at follow-up.…”

Section: Does Greater Pac Involvement Reduce a Child's Weight?mentioning

confidence: 99%

“…100 Moreover, among the 3 studies that included a no-treatment control group, all active treatments, including those with greater PAC involvement, achieved better child outcomes than the no-treatment control group. 97,98,106 In summary, results from randomized clinical trials provide mixed support for the notion that greater PAC involvement SD indicates standard deviation; BMIz, body mass index z score; %ile, percentile; BMI%ile, body mass index percentile; and BMI, body mass index. *Children in all treatment groups showed greater reductions in overweight status than nontreatment control children.…”

Section: Does Greater Pac Involvement Reduce a Child's Weight?mentioning

confidence: 99%

Evaluating Parents and Adult Caregivers as “Agents of Change” for Treating Obese Children: Evidence for Parent Behavior Change Strategies and Research Gaps

Faith¹,

Horn²,

Appel³

et al. 2012

Circulation

235

170

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Abstract-This scientific statement addresses parents and adult caregivers (PACs) as "agents of change" for obese children, evaluating the strength of evidence that particular parenting strategies can leverage behavior change and reduce positive energy balance in obese youth. The statement has 3 specific aims. The first is to review core behavior change strategies for PACs as used in family-based treatment programs and to provide a resource list. The second is to evaluate the strength of evidence that greater parental "involvement" in treatment is associated with better reductions in child overweight. The third is to identify research gaps and new opportunities for the field. This review yielded limited and inconsistent evidence from randomized controlled clinical trials that greater PAC involvement necessarily is associated with better child outcomes. For example, only 17% of the intervention studies reported differential improvements in child overweight as a function of parental involvement in treatment. On the other hand, greater parental adherence with core behavior change strategies predicted better child weight outcomes after 2 and 5 years in some studies. Thus, the literature lacks conclusive evidence that one particular parenting strategy or approach causally is superior to others in which children have a greater focus in treatment. A number of research gaps were identified, including the assessment of refined parenting phenotypes, cultural tailoring of interventions, examination of family relationships, and incorporation of new technologies. A conceptual model is proposed to stimulate research identifying the determinants of PAC feeding and physical activity parenting practices, the results of which may inform new treatments. The statement addresses the need for innovative research to advance the scope and potency of PAC treatments for childhood obesity. (Circulation. 2012;125:1186-1207.)Key Words: AHA Scientific Statements Ⅲ diet Ⅲ lifestyle Ⅲ nutrition Ⅲ obesity Ⅲ pediatrics Ⅲ preventionThe American Heart Association makes every effort to avoid any actual or potential conflicts of interest that may arise as a result of an outside relationship or a personal, professional, or business interest of a member of the writing panel. Specifically, all members of the writing group are required to complete and submit a Disclosure Questionnaire showing all such relationships that might be perceived as real or potential conflicts of interest.This statement was approved by the American Heart Association Science Advisory and Coordinating Committee on October 10, 2011. A copy of the document is available at http://my.americanheart.org/statements by selecting either the "By Topic" link or the "By Publication Date" link. To purchase additional reprints, call 843-216-2533 or e-mail kelle.ramsay@wolterskluwer.com.The American Heart Association requests that this document be cited as follows: Faith MS, Van Horn L, Appel LJ, Burke LE, Carson JAS, Franch HA, Jakicic JM, Kral TVE, Odoms-Young A, Wansink B, Wylie-Rosett J; on ...

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“…One such issue is that of a clinical (vs. statistical) significance of the weight losses achieved, i.e., whether or not a given treatment reduction is large enough to make any real therapeutic difference to the overweight subject. With the exception of that by Aragona et al (1975), controlled group studies have obtained relatively small mean losses; e.g., Kingsley and Shapiro's (1977) subjects averaged a loss of 3.5 lb in 8 weeks, while Weiss' (1977) four treatment groups showed mean reduction across 12 weeks that ranged from 0.7 to 2.9 lb. A second issue concerns the maintenance of weight reductions once the formal treatment period has ended.…”

Section: Introductionmentioning

confidence: 99%

“…Follow-up" data on children who have participated in behavioral weight-control programs are both limited and ambiguous. Of the studies that present such data, some (Altman et al, 1978;Hirsch and Altman, 1981;Rivinus et al, 1976;Weiss, 1977) report the successful maintenance of treatment losses, while others (Aragona et al, 1975;Kingsley and Shapiro, 1977) do not.…”

Section: Introductionmentioning

confidence: 99%