Kids need to lose weight? Set goals and work together

Families reap weight control benefits by engaging in behavioral treatment together

Rates of obesity have more than tripled among children and adolescents since the 1970s. What can be done about it? Research-proven treatments for obesity exist, but they rely on regular one-on-one meetings with a trained health coach. These “behavioral” treatments are seldom available outside of research studies in specialty medical centers.

Kaiser Permanente Washington Health Research Institute Senior Investigator Paula Lozano, MD, MPH found it works to give this same kind of behavioral treatment to groups of families in primary care. She published results of the Family Wellness Program in The Permanente Journal.

Strength in numbers, shared goals

The U.S. Preventive Services Task Force (USPSTF) recommends screening children for obesity from age 6 — and referring children who are obese to intensive behavioral treatment. This kind of treatment provides information about healthy eating and physical activity. It also gives parents and children a place to share their experiences and get social support. But that’s not all.

“Most important, behavioral treatment teaches parents and children skills like tracking their eating and activity, setting goals and holding themselves accountable for working toward those goals,” Lozano said. Behavioral treatment also involves taking a look at the child’s environment, including:

• The home
• School
• Friends’ homes
• Relatives’ homes

And then trying to promote healthy behaviors by making small changes across all these places where children eat and are active. “This approach has been proven to create and sustain healthy changes in lifestyle,” she said.

Easier said than done

Although this kind of treatment has been proven effective, it’s disappointingly hard to find. “That’s why we set out to adapt family-based behavioral treatment to a real-world setting: in this case, primary care,” she said. “And we found that it was feasible, families liked it, and parents and children lost weight.”

Out of the research center and into real life

“Parents told us that their children’s quality of life improved,” Lozano said.

“For kids, the way we measure quality of life includes experiences like being bullied or excluded, being unable to keep up with other children, and feeling worried or angry. When parents tell us that their kids feel better about themselves in social settings and are happier, that is a tangible benefit of this kind of program.”

However, sometimes supposed allies can work against you. Families did best when they had good social support from friends and relatives who joined in making healthy changes. But often a child’s other parent or grandparents didn’t “get with the program.” Instead, these key family members sabotaged the family’s attempts to adopt healthier habits. It takes a united and consistent effort to win against childhood obesity.

By Julian Rogers and Rebecca Hughes