Clinical efficacy of group-based treatment for childhood obesity compared with routinely given individual counseling

Abstract

Objective: The aim of the study was to compare the efficacy of group treatment stressing a health-promoting lifestyle with routine counseling in the treatment of childhood obesity. Design and subjects: Seventy obese children (weight for height 115-182%) aged 7-9 years were randomized either to routine counseling (two appointments for children) or to family-based group treatment (15 separate sessions for parents and children). These sessions included nutrition education, physical activity education and behavioral therapy. Outcome measures: Children's weights and heights were measured at baseline, after the 6-month intervention and after the 6-month follow-up. The change of weight for height based on Finnish growth charts was used as the primary, and changes in body mass index (BMI) and BMI standard deviation scores (BMI-SDS) as secondary outcome measures. Results: Children attending the group treatment lost more weight for height (6.8%) than children receiving routine counseling (1.8%) (P ¼ 0.001). The difference was significant when the data were analyzed in four groups by the cut-off limits of 0, À5 and À10% for the change in weight for height. The respective decreases in BMI were 0.8 vs 0.0 (P ¼ 0.003) and in BMI-SDS 0.3 vs 0.2 (P ¼ 0.022). The results remained similar in adjusted analyses. Both group and routine programs were feasible with a high, 87-99%, participation rate in sessions and appointments and very low, 3% or less, attrition rate from the programs. Six months after the intervention, beneficial effects were partly lost, but for changes in weight for height and BMI, the differences between the two treatment programs still were significant, and for BMI-SDS, there was a trend. Conclusions: Family-based group treatment that stresses a health-promoting lifestyle and is given separately for parents and children, offers an effective mode of therapy to treat obese school-aged children.

An Adaptation of Family-Based Behavioral Pediatric Obesity Treatment for a Primary Care Setting: Group Health Family Wellness Program Pilot

“…Families who completed the program reported an increase in behavioral skills use and experienced significant improvements in all health outcomes. Mean improvement in child Z-BMI was comparable with group family-based treatment interventions in the extant literature 13,[24][25][26] and was above the threshold for clinically meaningful improvement. 27 In addition, change in child quality of life reflected clinically meaningful improvement.…”

Long-term efficacy of group-based treatment for childhood obesity compared with routinely given individual counselling

“…3 Families with 7-9-year-old obese children (weight for height from 120 to 200%) were recruited, and the parents of 70 children (28 boys, 42 girls) decided to participate. At baseline, the mean age of the children was 8.1 years (s.d.…”

“…1,2 In the present study, the efficacy of group treatment and routine counselling is compared in the management of 7-9-year-old obese children in the long term, 2 and 3 years after the beginning of treatment. We have earlier published 3 that in the short term, for 1 year after the beginning of the intervention, group treatment was more effective than routine counselling.…”

Treating childhood obesity: Family background variables and the child's success in a weight‐control intervention

“…Percentages of those who do not finish interventions mostly average 20% 10,11,13,15 and of those who complete about 37% fail to reduce overweight more than 5%. 13,14 Particularly in childhood, such negative experiences should be avoided because motivation to control overweight decreases with each failure. 16 Thus, it seems expedient to identify those patients who probably will not succeed early enough to meet their needs more specifically, maybe by offering further or other intervention modules.…”

“…Besides behavioral therapy of eating and physical activity behaviors, dietary, and physical exercise courses, which have been regarded as significant components of weight-loss interventions, 5,6 treatment of obesity in childhood should involve the family environment. [7][8][9] Even though intervention programs have proven effective in reducing weight and have also shown reasonable long-term success, [10][11][12][13][14] far from all attendees respond to therapy. Percentages of those who do not finish interventions mostly average 20% 10,11,13,15 and of those who complete about 37% fail to reduce overweight more than 5%.…”