The Centre for Healthy Weights—Shapedown BC: A Family-Centered, Multidisciplinary Program that Reduces Weight Gain in Obese Children over the Short-Term

Abstract

The objective was to conduct a program evaluation of the Centre for Healthy Weights—Shapedown BC (CHW-SB), a family-centered, multidisciplinary program for obese children, by assessing the change in weight trajectories from program intake to completion. Secondary outcomes included changes in clinical, biochemical and psychological parameters, and in physical activity (PA) levels. The CHW-SB program was evaluated over 10 weeks. Data collection included anthropometric, metabolic, PA and psychological measures. Longitudinal mixed effects regression was performed to evaluate weight change from Phase 1 (before program on waitlist) to Phase 2 (during program). 238 children <18 years of age were referred to the program of which 119 were eligible for participation. There was a significant decrease in weight trajectory in children following program entry. Participants experienced an average .89% monthly increase before program entry, compared to a .37% monthly decline afterwards, a drop of 1.26% (p < 0.0001, 95%CI 1.08 to 1.44). zBMI (2.26 ± 0.33 to 2.20 ± 0.36, p < 0.001), waist circumference (99 ± 15.7 to 97 ± 16 cm, p < 0.0001) and fasting insulin (137 ± 94.8 to 121 ± 83.4 pmol/L, p < 0.001) also decreased in participants who attended the final visit. Significant improvements were seen in all measures of PA, self-concept, and anxiety. CHW-SB, a government-funded program, is the first obesity-treatment program to be evaluated in Canada. While short-term evaluation revealed significant improvements in adiposity, PA, and psychological measures, the lack of full follow-up is a limitation in interpreting the clinical effectiveness of this program, as drop-out may be associated with lack of success in meeting program goals. These data also emphasize the need for ongoing evaluation to assess the long-term implications of this unique program and ultimately optimize utilization of governmental resources.

Tackling overweight and obesity: does the public health message match the science?

“…Commonly identified methods included the provision of specific caloric goals [4-10], and use of pre-packaged meals or meal replacements to limit caloric consumption and restrict energy intake [4,7,11,12]. Of the 27 studies, 17 provided nutrition-education components, with common themes being reducing fat intake, limiting high-energy snack foods, reducing or eliminating consumption of sweetened beverages [6,12-18], and controlling portion sizes [12,13]. …”

“…Interventions used a variety of methods to achieve this aim. Common methods included providing specific exercise goals [4,9,15,21-24], requiring participants to complete structured exercise programs [6,7,11,13,21,25], or encouraging participants to increase their daily levels of physical activity without specific exercise goals. In addition, novel methods for increasing physical activity, such as locking devices for televisions [12] and use of active video games [26], were investigated.…”

Parents’ Views on Engaging Families of Middle School Students in Obesity Prevention and Control in a Multiethnic Population

“…The level and extent to which parents are incorporated into youth obesity prevention programs vary from programs holding separate classes for parents and children and others involving parents through home-based activities (13,17,26). Results from our study confirm previous findings that parents want to be integrated and involved in obesity prevention programs (16,27).…”

Fjölskyldumiðuð atferlismeðferð fyrir of feit börn

“…Engin laekkun varð á stöðluðum líkamsþyngdarstuðli barna í samanburðarhópi í þeirri rannsókn, sem er í samraemi við aðrar rannsóknir sem hafa sýnt að staðlaður líkamsþyngdarstuðull barna laekkar sjaldnast og haekkar heldur án virkrar meðferðar. 37,38 Niðurstöður þessarar rannsóknar, og þá sérlega sú niðurstaða að laekkun á líkamsþyngdarstuðli barna viðhélst tveimur árum eftir að meðferð lauk, renna því enn frekari stoðum undir gagnsemi meðferðar Epsteins í klínískum aðstaeðum á Íslandi.…”

“…Vert er að taka fram að í þessari rannsókn var ekki notast við samanburðarhóp, þar sem rannsakendum þótti ekki siðferðilega rétt að halda börnum frá meðferð við offitu í þetta langan tíma, þar sem fyrri rannsóknin á árangri meðferðarinnar hafði sýnt góðan árangur og þar var samanburðarhópur sem fékk hefðbundna meðferð sem gerði lítið gagn. Rannsóknir benda jafnframt til þess að börn yfir kjörþyngd eigi það til að þyngjast yfir tíma 37,38 og eru þessar niðurstöður því hvetjandi.…”