Obesity in children is difficult to treat, but it seems to be easier to treat
than adult obesity. The first step in treatment is to identify effective advice
relating to nutrition and physical activity. In most treatment studies the
macronutrient composition of the diet is not of major importance for treatment
outcome. In relation to physical activity fat-utilisation strategies have been
described. The second step includes appropriate approaches to lifestyle change.
In Europe there are no drugs approved for children, and surgery for children is
still limited to research projects. Thus, the major challenge is to develop
effective ways of changing lifestyle. Family therapy may be an effective
approach in preventing severe obesity from developing during puberty, and a
therapeutic strategy based on treatment studies is described. The family-therapy
techniques used here are intended to facilitate the family's own
attempts to modify their lifestyle, and to increase their own sense of
responsibility and readiness to change, i.e. these variables are the prime
targets during therapy. Thus, the family, not the therapist, assumes
responsibility for the changes achieved. This approach may be helpful in making
the therapeutic process less cumbersome for the therapist. Instead of the
therapist attempting to persuade the obese subjects to lose weight, it might be
more effective to teach them to control their eating patterns through their own
efforts. The treatment model includes structural family therapy and
solution-focused-brief therapy. The use of such a model makes it possible to
train therapists and health professionals to use an evidence-based intervention
model.