Family-focused approach in paediatric primary care proves effective for child weight loss
A groundbreaking family-based treatment for childhood obesity, developed by researchers at the University at Buffalo (UB), has demonstrated significant success in a multicenter study conducted in paediatric primary care settings. Previously available only in specialised clinics, this evidence-based treatment has now been implemented for the first time in four U.S. cities, targeting children aged 6-12 and their parents.
Published in the Journal of the American Medical Association, the study reveals that family-based treatment conducted in paediatricians’ offices leads to improved weight-loss outcomes not only for the treated child and parent but also for untreated siblings. The research, supported by the National Heart, Lung and Blood Institute, emphasises that the healthy behaviours promoted during the treatment extend beyond the immediate family members, potentially improving the overall health of the entire family.
In the study, three times as many children in the treatment group (27%) experienced a clinically meaningful reduction in median body mass index (BMI) compared to the usual care group (9%). These improvements in weight correlated with enhanced cardiometabolic outcomes, such as blood pressure, lipids, and glucose regulation. The success of this novel family-focused treatment, pioneered by senior author Leonard H. Epstein, has significant implications for the long-term health and well-being of the treated children.
The family-based treatment program involves the implementation of eating and activity plans, education in parenting and behavioural techniques, and the facilitation of support for positive behaviour changes within both the family and peer environments. In individualised sessions, parents and children are seen together, reviewing self-monitored eating and activity levels, treatment manuals, handouts, and setting goals for weight and behaviour.
The randomised clinical trial enrolled 452 children aged 6 to 12, with one parent, in primary care practices across Buffalo, Rochester, Columbus, and St. Louis. Half of the children received family-based treatment, while the other half received usual care. Notably, the treatment demonstrated positive outcomes across racial and ethnic backgrounds.
Children receiving family-based treatment showed a significant difference in percent over median BMI compared to those receiving usual care, with a reduction of 6.48%. Furthermore, parents experienced a reduction of 3.97% in BMI, and untreated siblings who were overweight had a reduction of 5.38%. These changes in BMI among family members were interrelated, suggesting that the treatment fosters the modelling of healthy behaviours and facilitates real change in the shared family environment.
The success of this behavioural intervention underscores the growing need for similar treatments in paediatric primary care. The study authors emphasise the necessity for “coaches” in primary care settings who can provide support for obesity treatment and address various behavioural issues, including anxiety, depression, and eating disorders.
The implementation of this family-focused approach not only ensures the immediate health of children but also equips them with lifelong healthy practices. The study’s positive outcomes highlight the potential for transforming paediatric primary care into a hub for comprehensive behavioural interventions, addressing a wide range of health-related concerns.
