BACKGROUND: Childhood obesity is a growing epidemic in family medicine with few clinical treatment options. We implemented and evaluated a group office-visit intervention by family physicians for overweight children and their parents, emphasizing nutrition and physical activity within a resiliency psychosocial model. METHODS: The intervention lasted for 3 months, with half of the children crossing over to intervention after 6 months in the study. Participants included 35 children who met eligibility criteria of being in third through fifth grades and having a body mass index (BMI) above the 85th percentile. The 3-month, 12-session intervention, "Choices," included topics on nutrition, physical activity, and resiliency. The sessions were developed for delivery by a family physician and a nutritionist who received training in positive psychology and resilience skills. Main outcome measures were BMI z scores for age and sex and z scores for weight by age and sex, as well as qualitative interviews to understand individual and family processes. RESULTS: The intervention resulted in a significant effect on one primary outcome, BMI z score (-0.138 per 9 months [P = .017]) and a trend toward significance on the weight for age z score (-0.87 per 9 months [P = .09]). The net shift of activity from the low metabolic equivalents (METs) to the high METs had an intervention effect of 2.84 METs (P = .037). Families reported lasting changes in behaviors and attitudes. DISCUSSION: The innovative approach used in this study demonstrated modest efficacy in reducing BMI z score, changing physical activity levels, and possibly shifting family dynamics.
BACKGROUND:Childhood obesity is a growing epidemic in family medicine with few clinical treatment options. We implemented and evaluated a group office-visit intervention by family physicians for overweight children and their parents, emphasizing nutrition and physical activity within a resiliency psychosocial model. METHODS: The intervention lasted for 3 months, with half of the children crossing over to intervention after 6 months in the study. Participants included 35 children who met eligibility criteria of being in third through fifth grades and having a body mass index (BMI) above the 85th percentile. The 3-month, 12-session intervention, "Choices," included topics on nutrition, physical activity, and resiliency. The sessions were developed for delivery by a family physician and a nutritionist who received training in positive psychology and resilience skills. Main outcome measures were BMI z scores for age and sex and z scores for weight by age and sex, as well as qualitative interviews to understand individual and family processes. RESULTS: The intervention resulted in a significant effect on one primary outcome, BMI z score (-0.138 per 9 months [P = .017]) and a trend toward significance on the weight for age z score (-0.87 per 9 months [P = .09]). The net shift of activity from the low metabolic equivalents (METs) to the high METs had an intervention effect of 2.84 METs (P = .037). Families reported lasting changes in behaviors and attitudes. DISCUSSION: The innovative approach used in this study demonstrated modest efficacy in reducing BMI z score, changing physical activity levels, and possibly shifting family dynamics.
Authors: K Resnicow; F McMaster; S Woolford; E Slora; A Bocian; D Harris; J Drehmer; R Wasserman; R Schwartz; E Myers; J Foster; L Snetselaar; D Hollinger; K Smith Journal: Pediatr Obes Date: 2011-12-13 Impact factor: 4.000
Authors: David S Freedman; Nancy F Butte; Elsie M Taveras; Alyson B Goodman; Cynthia L Ogden; Heidi M Blanck Journal: J Pediatr Date: 2017-04-19 Impact factor: 4.406
Authors: Andrew W Brown; Douglas G Altman; Tom Baranowski; J Martin Bland; John A Dawson; Nikhil V Dhurandhar; Shima Dowla; Kevin R Fontaine; Andrew Gelman; Steven B Heymsfield; Wasantha Jayawardene; Scott W Keith; Theodore K Kyle; Eric Loken; J Michael Oakes; June Stevens; Diana M Thomas; David B Allison Journal: Obes Rev Date: 2019-08-19 Impact factor: 9.213
Authors: Judith Wylie-Rosett; Adriana E Groisman-Perelstein; Pamela M Diamantis; Camille C Jimenez; Viswanathan Shankar; Beth A Conlon; Yasmin Mossavar-Rahmani; Carmen R Isasi; Sarah N Martin; Mindy Ginsberg; Nirupa R Matthan; Alice H Lichtenstein Journal: Int J Behav Nutr Phys Act Date: 2018-01-22 Impact factor: 6.457
Authors: David S Freedman; Nancy F Butte; Elsie M Taveras; Elizabeth A Lundeen; Heidi M Blanck; Alyson B Goodman; Cynthia L Ogden Journal: Obesity (Silver Spring) Date: 2017-02-28 Impact factor: 5.002
Authors: Emma Mead; Tamara Brown; Karen Rees; Liane B Azevedo; Victoria Whittaker; Dan Jones; Joan Olajide; Giulia M Mainardi; Eva Corpeleijn; Claire O'Malley; Elizabeth Beardsmore; Lena Al-Khudairy; Louise Baur; Maria-Inti Metzendorf; Alessandro Demaio; Louisa J Ells Journal: Cochrane Database Syst Rev Date: 2017-06-22
Authors: Sam Liu; Joy Weismiller; Karen Strange; Lisa Forster-Coull; Jennifer Bradbury; Tom Warshawski; Patti-Jean Naylor Journal: BMC Pediatr Date: 2020-08-20 Impact factor: 2.125