Guided self-help program shows effectiveness in treating pediatric obesity
A new study compared a leading family-based treatment (FBT) obesity program with a new guided self-help (GSH) program and found families who participated in the GSH program were more likely to maintain attendance.
The research, published in the journal, Pediatrics, and conducted by investigators at the University of California San Diego, explored the differences in each treatment model as it relates to attendance and child weight status. The GSH program was described as “less intense” and delivered in a primary care setting, while the FBT is considered a more traditional family-based behavioral treatment delivered in an academic center.
In the clinical trial, 164 children between 5 and 13 years old and their parents were randomly assigned to one of the two programs. Participants were recruited from two clinic sites in San Diego County, which primarily serve Latino families. The prevalence of childhood obesity in these neighborhoods (Escondido and Chula Vista) is 38 percent.
The traditional FBT program consists of 20 one-hour group sessions over six months. Because FBT is held at academic research centers, there are often geographical constraints, according to researchers. Attrition rates in these programs are high, with many parents noting scheduling issues, transportation difficulties, and competing work and family responsibilities as contributing factors.
In response to these challenges, the GSH model was developed to provide shorter treatment sessions and greater scheduling flexibility. The new program consists of 14 visits, each 20 minutes in length and held at the child’s primary care clinic. Families are given material to practice between sessions in a self-directed manner, and then meet individually with a health coach to review and troubleshoot strategies.
According to the study, both programs teach families how to self-monitor food intake, set healthy goals, and modify the home environment to promote behavioral change. Additional sessions address topics of body image, bullying and emotional health.
“The program is not framed around weight loss per se, but about developing healthy lifestyle behaviors,” said the study’s corresponding author Kyung Rhee, MD, professor of pediatrics at UC San Diego School of Medicine in a statement.
The results found that children in both groups showed significant reductions in their body mass index percentiles, which were largely maintained at the time of the six-month follow-up. However, families assigned to GSH showed a nearly 70 percent lower risk of attrition and reported greater satisfaction and convenience. GSH participants attended more than half of the treatment sessions while FBT participants only attended one in five sessions on average.