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

Abstract

Objective: To analyze whether caregiver and family characteristics predict success in a family-based lifestyle intervention program for children and adolescents.Method: Participants were 111 overweight and obese children (7-15 years) who attended a family-based weightreduction program. Body mass index (BMI) and BMI standard deviation scores (BMI-SDS) of index child, and BMI of family members, family adversity characteristics, depression, and attachment attitudes of the primary caregiver were assessed.Results: Risk of nonresponse ( 5% reduction of BMI-SDS or dropout) was elevated in older children, cases with obese sibling(s), maternal depression, and avoidant attachment attitude. In a logistic regression analysis, maternal depression, attachment attitude, and age of index child explained common variance whereas the presence of obese siblings explained unique variance in nonresponding.Discussion: To meet the specific needs of all participating families and to prevent the discouraging experience of failure in weight-control interventions, our data suggest that special support should be provided to adolescents with obese siblings, and cases of maternal depression, and avoidant attachment attitude. V V C 2009 by Wiley Periodicals, Inc.

The influence of familial predisposition to cardiovascular complications upon childhood obesity treatment

“…When grouped according to familial predispositions, girls with familial obesity responded better to treatment than girls with no familial obesity, though girls without familial obesity reduced their degree of obesity as well. This finding was contrary to expectations since other studies have shown that familial obesity is associated with a poorer response to treatment [9][10][11][12]14]. However, familial predispositions to obesity related cardiovascular complications were in general not associated with the changes in BMI SDS in the obese children and adolescents enrolled in the multidisciplinary treatment protocol practised in the present study.…”

“…Finally, the intervention approaches and the follow-up times during treatment varied from 12 [10,12,14] to 36 months [9] in-between these studies. Furthermore, many of the cited studies outline the effect of a familial predisposition to obesity [9][10][11][12][14][15][16][17][18] and only a few studies outline the effect of a familial predisposition to T2DM [12]. The studies concerning CVD only analyse the degree of obesity and not how these conditions influence childhood obesity treatment [20,21].…”

“…In order to treat childhood obesity effectively, an early intervention is of great importance, and a multidisciplinary approach involving the family combining counselling on diet, behaviour, and activity seems pivotal, but the response to treatment may be inadequate for some patients [8][9][10][11][12][13]. One explanation may be the metabolic state of the children and their families, since it has been shown that a familial predisposition to obesity is associated with a poorer response to treatment [9,10,12,14].…”

“…One explanation may be the metabolic state of the children and their families, since it has been shown that a familial predisposition to obesity is associated with a poorer response to treatment [9,10,12,14]. Furthermore, a familial predisposition to obesity has been associated with the development of obesity in childhood [15][16][17][18].…”

“…Furthermore, a familial predisposition to obesity has been associated with the development of obesity in childhood [15][16][17][18]. The influence of a familial predisposition to obesity has been described in regards to parents [9,11,12,[14][15][16] especially the weight status of the mother [9,11,15], siblings [10], and grandparents [17,18] indicating that the high prevalence of overweight and obese children is dependent upon obesity among the family members.…”