Tuesday, August 3, 2010

Successfully Treating Obesity in Children: Results from an 8-year follow-up study

A recent article in the journal Behaviour, Research and Therapy* (a well-respected psychology journal) caught my eye, and thought it was worth the time to describe the findings here.

Following a initial screening process, 90 children took part in a weight control program. The average age of the children was 10 years, and all were overweight (28%) or obese (72%) at the start of treatment. This was a multidisciplinary treatment program involving a pediatrician, dietician and psychologist. The overall program consisted of three parts:

(1) teaching healthy eating habits

(2) achieving a moderate amount exercise

(3) learning cognitive-behavioural techniques (the psychology piece)

The program lasted 1 year in total -- there was an acute treatment phase that consisted of 6 biweekly sessions (group and individual) over twelve weeks, followed by a follow-up phase where the health professionals met with parents and children to encourage lifestyle changes and to maintain motivation.

As mentioned, the goal of the program was weight control and not weight loss. Health professionals are coming to appreciate the benefits of weight stabilization alone, as relatively small changes in weight can yield major health benefits.

The researchers then contacted the same children approximately 8 years after the start of the treatment program. They found that the program was successful immediately following the end of treatment (i.e., the post-treatment results). However, even more impressive were the follow up results -- the children (who were now adolescents) had reduced their BMI by an average of 8%. This is a significant accomplishment as maintaining weight loss over a period of years can be quite difficult.

Furthermore, the researchers identified some notable variables that predicted successful outcome: (1) the children's self-esteem -- those children who had higher levels of self-worth were more successful at keeping the weight off, and (2) their mother's mental health -- when mothers had higher levels of psychological distress, their children tended to not have as much success with weight loss.

It is important to remember that these are only correlations, so we cannot say that poor self-esteem directly caused some children to struggle in the program. However, it is easy to conceptualize how weight loss and self-esteem work together. Also, this 8-year study was not a randomized control trial, so it too is correlational in nature.

Overall, the findings are encouraging because it indicates that childhood obesity can be successfully treated. Indeed, at the start of treatment, 72% of the children were classified as obese -- whereas that number had dropped to 47% by the end of treatment. In fact, 66% of the children had maintained weight stabilization (i.e., they did not gain weight over the 8 year period) -- very important from a weight prevention standpoint.

Imagine if a new diet drug were found to prevent weight gain in the majority of children over an 8 year period -- you would read the following headlines:

"New Medication May Lead to Millions is Health Care Savings"
 or

"Wonder Drug the Key to Saving Our Children's Health"

Unfortunately, you won't see such headlines for this or other such studies. Improving diet, exercise and psychological health isn't a corporate money-maker -- but it is arguably the best approach to dealing with the growing obesity epidemic.

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