Weight loss is a complex problem that is influenced by diet, physical activity, emotional issues, and environmental factors. For children weight loss is further complicated by the fact that they have little control over the food that they eat. Children also often pick up lifestyle habits from people around them. If a child lives in a household with overweight caretakers it may be harder for the child to develop healthy habits related to nutrition. In some cases, family habits may actually work against the child's weight loss program.
Yale University investigated the influence of family involvement in a weight management program for children. The study, published in theJournal of American Medical Association, found that family-based counseling led to greater decrease in body mass index (BMI) in children.
The randomized trial included 209 children aged 8-16 years that were overweight. They were randomized to a traditional weight management program that met once every six months or an intensive family-based program that included exercise, nutrition, and behavior modification for the entire family. The family-based program met twice weekly for the first six months, twice monthly for the next six months, and no interaction in the last 12 months.
Changes after the first 12 months in the family-based intervention vs. traditional intervention:
- Weight increased by an average of 0.66 pounds (0.3 kg [kilograms]) vs. 17 pounds (7.7 kg)
- BMI (body mass index-measure of weight by height) decreased by an average of 1.7 kg/m² (kilograms per meter squared) vs. increase of 1.6 kg/m²
- Body fat decreased by an average of 4% vs. increase of 2%
There was a 47% dropout rate of participants by 12 months. The benefits of the family-based intervention was maintained through 24 months in 36% of the participants that were available for follow-up.
Randomized trials are considered one of the most reliable trial designs. This trial did have a high dropout rate during the first 12 months and there were few participants available for follow-up at 24 months. The loss of this many participants may decreases the reliability of the results but are unfortunately common in weight-loss trials.
Family support can play an important role in weight loss for children and teens. If the teen is trying to make changes, but is surrounded by easy access or reminders of bad habits, it can be easy to stray from healthy habits. If you are a parent or caretaker, keep in mind that your example influences your children. Make sure you are eating things you want your child to eat like fruits and vegetables. Add physical activity to family plans like a walk after dinner, hikes on the weekend, or even find games that are active. And if your child is overweight, consider how your habits are affecting your child' health. Getting involved in his steps for weight loss may help both your child and yourself.
Savoye M, Nowicka P, Shaw M, et al.
Long-term results of an obesity program in an ethnically diverse pediatric population.
Pediatrics. 2011 Mar;127(3):402-10.
Savoye M, Shaw M, Dziura J, et al.
Effects of a weight management program on body composition and metabolic parameters in overweight children: a randomized controlled trial.
JAMA. 2007 Jun 27;297(24):2697-704.
Last reviewed April 2011 by Brian P. Randall, MD
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