Self-guided family-based treatment effective for childhood obesity

Self-guided family-based treatment effective for childhood obesity

Family-based behavioral treatment (FBT) is a clinically proprietary approach to treating children with obesity that involves a health professional working with the family's skills. While FBT has traditionally been led by clinicians, researchers at the University of California San Diego's Center for Healthy Eating and Activity Research have now found that self-guided FBT is just as effective in helping children lose weight compared to traditional approaches. It is also more flexible in terms of scheduling, costs significantly less, and requires fewer contact hours with a provider. The results were recently published inPediatrics.

Traditional FBT is an effective treatment for children with obesity, but can be time-consuming, can only be offered at certain times, and is expensive, making families facing difficult financial circumstances less likely to seek treatment. By providing the same core skills as traditional FBT in a more flexible and condensed format, we can increase access to treatment for families who may not be able to participate in traditional group-based programs. “

Kerri Boutelle, Ph.D.,Senior Author,Director of Chear and Professor in the Departments of Pediatrics and Psychiatry at the UC San Diego School of Medicine and the UC San Diego Herbert Wertheim School of Public Health and Human Longevity Science

According to the National Health and Nutrition Examination Survey (NHANES), about one in five children in the United States are obese. Obesity is associated with a variety of negative health outcomes in children, such as: B. an increased risk of developing type 2 diabetes, high blood pressure and asthma. Childhood obesity is also linked to mental health problems such as depression, anxiety, low self-esteem and social isolation. Unlike adult obesity, which is often managed individually, helping children is a family effort.

Researchers developed a guided, self-help version of FBT that can be delivered over 20-minute biweekly visits and provides written educational materials for families between sessions. Traditional FBT is more time-intensive and is offered in weekly 60-minute parent and child group sessions and 20-minute bi-weekly sessions. To determine whether the self-guided approach was as effective as standard FBT, researchers randomly assigned 150 parent/child pairs to receive either traditional or self-guided FBT. They then compared the children's weight loss during treatment and at follow-up visits six, 12 and 18 months later.

The researchers found that self-guided FBT resulted in children losing weight similar to traditional FBT, but with much less contact time with a provider: 5.3 hours for self-guided versus 23 hours for traditional FBT. The cost of self-led FBT was also significantly lower than traditional FBT: $1,498 per family for self-led versus $2,775 per family for traditional FBT.

The study demonstrates the effectiveness of self-guided FBT, offers a better solution to the growing childhood obesity crisis, and throws a wrench into the idea that it helps with weight loss.

“Previous studies suggest that outcomes are improved with more contact time, but our results show that it may not be that simple,” Boutelle said. "We find that the most important thing is working with parents, which can be done without a trained clinician. While some families may benefit from the standard approach, it may help us have a broader impact on the childhood obesity epidemic."

Co-authors of the study include Kyung E. Rhee, Rebecca S. Bernard, Dawn M. Eichen and Natacha Akshoomoff and Michael A. Manzano at the UC San Diego School of Medicine; David R. Strong and Cheryl Am Anderson at the UC San Diego Herbert Wertheim School of Public Health and Human Longevity Science; Bess H. Marcus at Brown University and Scott Crow at the University of Minnesota.

The study was funded by the National Institutes of Health (grants R01DK10868, UL1TR001442).

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