1.
Camp-based family treatment of childhood obesity: randomised controlled trial.
Benestad, B, Lekhal, S, Småstuen, MC, Hertel, JK, Halsteinli, V, Ødegård, RA, Hjelmesæth, J
Archives of disease in childhood. 2017;(4):303-310
-
-
Free full text
-
Abstract
OBJECTIVE To compare the effectiveness of a 2-year camp-based family treatment programme and an outpatient programme on obesity in two generations. DESIGN Pragmatic randomised controlled trial. SETTING Rehabilitation clinic, tertiary care hospital and primary care. PATIENTS Families with at least one child (7-12 years) and one parent with obesity. INTERVENTIONS Summer camp for 2 weeks and 4 repetition weekends or lifestyle school including 4 days family education. Behavioural techniques motivating participants to healthier lifestyle. MAIN OUTCOME MEASURES Children: 2-year changes in body mass index (BMI) SD score (SDS). Parents: 2-year change in BMI. Main analyses: linear mixed models. RESULTS Ninety children (50% girls) were included. Baseline mean (SD) age was 9.7 (1.2) years, BMI 28.7 (3.9) kg/m2 and BMI SDS 3.46 (0.75). The summer-camp children had a lower adjusted estimated mean (95% CI) increase in BMI (-0.8 (-3.5 to -0.2) kg/m2), but the BMI SDS reductions did not differ significantly (-0.11 (-0.49 to 0.05)). The 2-year baseline adjusted BMI and BMI SDS did not differ significantly between summer-camp and lifestyle-school completers, BMI 29.8 (29.1 to 30.6) vs 30.7 (29.8 to 31.6) kg/m2 and BMI SDS 2.96 (2.85 to 3.08) vs 3.11 (2.97 to 3.24), respectively. The summer-camp parents had a small reduction in BMI (-0.9 (-1.8 to -0.03) vs -0.8 (-2.1 to 0.4) in the lifestyle-school group), but the within-group changes did not differ significantly (0.3 (-1.7 to 2.2)). CONCLUSIONS A 2-year family camp-based obesity treatment programme had no significant effect on BMI SDS in children with severe obesity compared with an outpatient family-based treatment programme. TRIAL REGISTRATION NUMBER NCT01110096.
2.
Preventing weight gain and obesity: indirect effects of the family check-up in early childhood.
Smith, JD, Montaño, Z, Dishion, TJ, Shaw, DS, Wilson, MN
Prevention science : the official journal of the Society for Prevention Research. 2015;(3):408-19
-
-
Free full text
-
Abstract
The early signs of obesity are observable in early childhood. Although the most promising prevention approaches are family-centered, few relevant early prevention programs exist. This study evaluated the effects of an evidence-based, home-visiting intervention, the Family Check-Up (FCU), on the trajectory of children's weight gain. The FCU was designed to prevent the development of behavior problems by improving family management practices; children's weight has not been an explicit target. On the basis of previous research and conceptual models, we hypothesized that intervention effects on parenting practices, specifically caregivers' use of positive behavior support (PBS) strategies in toddlerhood, would mediate improvements in children's weight trajectories. A total of 731 indigent caregiver-child dyads from a multisite randomized intervention trial were examined. Observational assessment of parenting and mealtime behaviors occurred from age 2-5 years. The child's body mass index (BMI) was assessed yearly from age 5-9.5 years. Path analysis with a latent growth model revealed a significant indirect effect of the FCU on the trajectory of BMI in later childhood. Improvements in caregivers' PBS in toddlerhood, which was related to the nutritional quality of the meals caregivers served to the child during the mealtime task, served as the intervening process. Furthermore, findings indicate that the FCU prevents progression to overweight and obese status amongst at-risk children. These study results add to existing evidence that has demonstrated that family-based interventions aimed at improving general family management skills are effective at preventing weight gain. Future directions are discussed.
3.
[Long-term evaluation of a psychological training for obese children and their parents (TAKE)].
Roth, B, Munsch, S, Meyer, AH
Praxis der Kinderpsychologie und Kinderpsychiatrie. 2011;(4):304-21
Abstract
Cognitive-behavioral parent-child-programmes have shown the best effects in treating childhood obesity so far. With TAKE (Training adipöser Kinder und ihrer Eltern) we introduce a psychologically-informed training, that includes physical activity, nutrition and eating behavior but also addresses psychological issues like self-confidence, body image, social and anti-bullying skills. Long-term data from up to 64 month-follow-up showed moderate effects on body-mass index standard deviation scores (BMI-SDS), and positive effects on children's psychological wellbeing. Maternal psychopathology predicted the course of BMI-SDS in children. Results underline the importance of psychological treatment for obese children to facilitate weight change and to reduce their psychological vulnerability which in turn may prevent the further development of behavior problems, eating disorders and affective disorders.