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Childhood obesity treatment: targeting parents exclusively v. parents and children

Published online by Cambridge University Press:  08 March 2007

Moria Golan*
Affiliation:
School of Nutritional Sciences, The Hebrew University of Jerusalem, Rehovot, Israel Shahaf, Community Comprehensive Services for Eating Disorders, Israel
Vered Kaufman
Affiliation:
School of Nutritional Sciences, The Hebrew University of Jerusalem, Rehovot, Israel
Danit R. Shahar
Affiliation:
School of Nutritional Sciences, The Hebrew University of Jerusalem, Rehovot, Israel The S. Daniel Abraham International Center for Health and Nutrition, Ben-Gurion University of the Negev, Beer-Sheva, Israel
*
*Corresponding author: Dr Moria Golan, fax +972 8 934 8953, email[email protected]
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Abstract

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There is a consensus that interventions to prevent and treat childhood obesity should involve the family; however, the extent of the child's involvement has received little attention. The goal of the present study was to evaluate the relative efficacy of treating childhood obesity via a family-based health-centred intervention, targeting parents alone v. parents and obese children together. Thirty-two families with obese children of 6–11 years of age were randomised into groups, in which participants were provided for 6 months a comprehensive educational and behavioural programme for a healthy lifestyle. These groups differed in their main agent of change: parents-only v. the parents and the obese child. In both groups, parents were encouraged to foster authoritative parenting styles (parents are both firm and supportive; assume a leadership role in the environmental change with appropriate granting of child's autonomy). Only the intervention aimed at parents-only resulted in a significant reduction in the percentage overweight at the end of the programme (P=0·02) as well as at the 1-year follow-up meeting.The differences between groups at both times were significant (P<0·05). A greater reduction in food stimuli in the home (P<0·05) was noted in the parents-only group. In both groups, the parents' weight status did not change. Regression analysis shows that the level of attendance in sessions explained 28% of the variability in the children's weight status change, the treatment group explained another 10%, and the improvement in the obesogenic load explained 11% of the variability. These results suggest that omittingthe obese child from active participation in the health-centred programme may be beneficial for weight loss and for the promotion of a healthy lifestyle among obese children.

Type
Research Article
Copyright
Copyright © The Nutrition Society 2006

References

Barlow, SE & Dietz, WHObesity evaluation and treatment:Expert Committee Recommendations. Pediatrics 1998 102, 111.CrossRefGoogle ScholarPubMed
Baumrind, DCurrent patterns of parental authority. Dev Psychol Monogr 1971 4, 101103.CrossRefGoogle Scholar
Birch, LL & Davidson, KKFamily environmental factors influencing the developing behavioral controls of food intake and childhood overweight. Pediatr Clin N Am 2001 48, 893907.CrossRefGoogle ScholarPubMed
Buri, JRParental authority questionnaire. J Pers Assess 1991 57, 110119.CrossRefGoogle ScholarPubMed
Buri, JR, Louiselle, PA, Misukanis, TM & Mueller, RAEffects of parental authoritarianism and authoritativeness on self esteem. Pers Soc Psychol 1988 14B, 271282.Google Scholar
Cole, TJ, Bellizzi, MC, Flegal, KM & Dietz, WHEstablishing a standard definition for child overweight and obesity worldwide:international survey. BMJ 2000 320, 12401243.CrossRefGoogle ScholarPubMed
Dietz, WH, Gortmaker, SLPreventing obesity in children and adolescents. Annu Rev Publ Health 2001 22, 337353.CrossRefGoogle ScholarPubMed
Epstein, LHFamily-based behavioral intervention for obese children. Int J Obes 1996 20, Suppl. 1, S14S21.Google ScholarPubMed
Epstein, LH, Constance, CG, Hollie, AR, Beddome, M, Collen, KK & Paluch, RA\ Increasing fruit and vegetable intake and decreasing fat and sugar intake in families at risk for childhood obesity. Obes Res 2001 9, 171178.CrossRefGoogle ScholarPubMed
Epstein, LH, Myers, MD, Raynor, HA & Saelens, BETreatment of pediatric obesity. Pediatrics 1998 101, 554570.CrossRefGoogle ScholarPubMed
Epstein, LH, Valoski, AM, Vara, LS, McCurley, J, Wisniewski, L, Kalarchian, MA, Klein, KR, & Shrager, LRThe effects of decreasing sedentary behaviour and increasing activity on weight change in obese children. Health Psychol 1995 14, 109115.CrossRefGoogle ScholarPubMed
Epstein, LH, Valoski, AM, Wing, RRTen year follow-up of behavioral, family-based treatment for obese children. JAMA 1990 264, 25192523.CrossRefGoogle ScholarPubMed
Epstein, LH, Wing, RR, Koeske, R, Andrasik, F & Ossip, DJChild and parent weight loss in family-based behavior modification programs. J Consult Clin Psychol 1981 49, 674685.CrossRefGoogle ScholarPubMed
Epstein, LH, Wing, RR, Steranchak, L, Dickson, B & Michelson, JComparison of family based behavior modification and nutrition education for childhood obesity. J Pediatr Psychol 1980 5, 2536.CrossRefGoogle ScholarPubMed
Glenny, AM, O'Meara, S, Melville, A, Sheldon, TA & Wilson, CThe treatment and prevention of obesity: a systemic review of the literature. Int J Obes 1997 21, 715737.CrossRefGoogle Scholar
Golan, M, Fainaru, M, Weizman, ARole of behavior modi-fication in the treatment of childhood obesity with the parents as the exclusive agents of change. Int J Obes 1998a 22, 18.CrossRefGoogle Scholar
Golan, M, Weizman, A, Apter, A & Fainaru, MReliability and validity of the family eating and activity habits questionnaire. Eur J Clin Nutr 1998b 52, 771777.CrossRefGoogle ScholarPubMed
Golan, M, Weizman, A, Apter, A & Fainaru, MParents as the exclusive agents of change in the treatment of childhood obesity. Am J Clin Nutr 1998c 67, 11301138.CrossRefGoogle ScholarPubMed
Golan, M, Fainaru, M & Weizman, AFamilial approach to the treatment of childhood obesity: a conceptual model. J Nutr Educ 2001 33, 102106.CrossRefGoogle Scholar
Hill, JO & Peters, JCEnvironmental contributions to the obesity epidemic. Science 1998 280, 13711374.CrossRefGoogle Scholar
Israel, AC, Guile, CA, Baker, JE & Silverman, WKAn evaluation of enhanced self-regulation training in the treatment of childhood obesity. J Pediatr Psychol 1994 19, 737749.CrossRefGoogle ScholarPubMed
Israel, AC, Stolmaker, L & Andrian, CAThe effects of training parents in general child management skills on a behavioral weight loss program for children. Behav Ther 1985 16, 169180.CrossRefGoogle Scholar
Johnson, SL, Birch, LLParents' and children's adiposity and eating style. Pediatrics 1994 94, 653661.CrossRefGoogle ScholarPubMed
Lerner, S & Lerner, HRA systemic approach to the resistance – theoretical and technical consideration. AmJ Psychother 1983 37, 339387.Google Scholar
Mendonca, PJ & Brehm, SSEffects of choice on behavioral treatment of overweight children. J Soc Clin Psychol 1983 1, 343353.CrossRefGoogle Scholar
Muller, MJ, Asbeck, I, Mast, M, Langnase, K & Grund, APrevention of obesity – more than intention. Concept and first results of the Kiel Obesity Prevention Study (KOPS). Int J Obes 2001 25,Suppl. 1, S66S74.CrossRefGoogle ScholarPubMed
Patton, GC, Johnson-Sabine, E, Wood, K, Mann, AH & Wakeling, AAbnormal eating attitudes in London school girls – a prospective epidemiologic study: outcome at twelve month follow-up. Psychol Med 1990 20, 383394.CrossRefGoogle Scholar
Satter, EMShould the obese child diet? In Evaluation and Management of Eating Disorders, pp (Clark, KL, Parr, RB, Castelli, WPChampaign, IL:. Life Enhancement Publications. 1988. 6175Google Scholar
Satter, EMInternal regulation and the evolution of normal growth as the basis for prevention of obesity in children. J Am Diet Assoc 1996 96, 860886.CrossRefGoogle ScholarPubMed
Summerbell, CD, Ashton, V, Campbell, KJEdmunds, L, Kelly, S& Waters, EInterventions for treating obesity in children. Cochrane Database Sys Rev 2003 3, CD001872.Google Scholar
Thompson, JK, Coovert, MD, Richards, KJ, Johnson, S & Cattarin, JDevelopment of body image, eating disturbance, and general psychological functioning in female adolescents: covariance structural modeling and longitudinal investigations. Int J Eat Disord 1995 18, 221236.3.0.CO;2-D>CrossRefGoogle Scholar
World Health Organization Obesity: Preventing and Managing the Global Epidemic: Report of a WHO Consultation on Obesity. Geneva, 3–5 June 1997 Geneva:. WHO 1998Google Scholar