Make Kids' Weight Loss a Family Affair, Study Suggests

If parent and preschooler are both overweight, tackling it together works best, researchers say

Wednesday, July 30, 2014

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WEDNESDAY, July 30, 2014 (HealthDay News) -- Parents who want to help their preschooler shed excess pounds may want to team up with their child, new research suggests.

Youngsters whose parents joined them in a supervised behavioral modification program gained less weight than their peers who were enrolled in a traditional child-only program (an average difference of about four pounds over two years). Their parent partners also benefited, losing almost 15 pounds over two years, according to the study.

"In a nutshell, we found that with supervised expert guidance in a primary care setting, it's possible to help preschoolers gain weight at a healthier pace as they grow, and at the same time also help parents lose, too," explained study lead author Dr. Teresa Quattrin, a professor at the University at Buffalo, and pediatrician-in-chief at the Women & Children's Hospital of Buffalo in Buffalo, N.Y.

"But when the focus is on children alone you see less of a benefit for them," she added. "And obviously no benefit for the parents. So this family approach is a win-win."

Quattrin and her colleagues published their findings in the August issue of Pediatrics.

Weight problems often start at a young age. Nearly one-quarter of U.S. preschoolers are heavier than they should be, according to background information in the study. But, excess weight this early in childhood is a relatively new problem, so experts don't yet know the best way to treat overweight in this young group of kids.

To explore a potential treatment option, the study authors enlisted almost 100 children in the Buffalo area who were between the ages of 2 and 5 years.

All were either overweight or obese, and all had at least one parent who was also struggling with excess weight.

For one year, half the parents attended 13 one-hour group sessions in a primary care setting. During that time, all were given standard weight-loss information solely aimed at helping their child shed weight.

The remaining parents received the same general advice. But in addition, all were given hands-on guidance -- in person and by phone -- from "practice enhancement assistants" with training in psychology, nutrition and exercise science.

The goal: to change the whole family's behavior regarding food consumption and physical activity.

For example, practice enhancement assistants discussed the need for appropriate food portions and caloric content, alongside the dangers of consuming foods loaded up with too much sugar, fat, or artificial sweeteners.

Parents in the child-parent team group were also instructed to keep food diaries and progress graphs for themselves and their children, and were given weekly weight loss goals for all concerned.

The result: after tracking all participants for one year following treatment completion, investigators found that the preschoolers enrolled in the family-based program gained an average of 12 pounds over a two-year period. This compared with a gain of about 16 pounds among those enrolled in the traditional child-only program.

What's more, parents who participated in the family-based program themselves lost an average of 14 pounds in the same timeframe, compared with basically no weight loss whatsoever among parents in the child-only program.

Quattrin stressed that there's no reason to think similar programs wouldn't work equally well in helping families with older kids.

But what about parents who might be interested in a do-it-yourself family effort, one that doesn't rely on expert guidance?

"I don't know if we have the research yet to show whether or not families who try this on their own outside of a specialized weight management environment can be as successful in the long run," Quattrin noted. "It's very helpful to have this kind of guidance, so that the dietary and exercise information that is out there is not misinterpreted," she added.

"But at the same time, it's important that parents know that you really don't have to be 100 percent successful. It's not all or nothing," she said.

"What's important is that parents make a family-based commitment to get soda out of the house, to increase the amount of vegetables they eat, to learn more about portion size, etc. These are certainly all changes families can make if they really want to, particularly if they do it in consultation with their primary care doctor who can, at minimum, offer help and advice. So I'd say that our message should be a positive one: that a healthier lifestyle is within everyone's reach," Quattrin said.

Lona Sandon, a registered dietician and an assistant professor of clinical nutrition at the University of Texas Southwestern Medical Center at Dallas, said the current findings echo those of previous studies.

"Previous studies have shown that preschoolers and young children do see their parents as role models and will mimic parent behaviors including what they eat," Sandon noted. "Parents influence what and how much children will eat through modeling. They also have complete control over the food and activity opportunities that are available for their children," she pointed out.

"[So] parents must be part of programs that address childhood obesity, because they must be on the same page with what the children are learning and behaviors that need to change," Sandon said.

SOURCES: Teresa Quattrin, M.D., UB distinguished professor, University at Buffalo, and pediatrician-in-chief, Women & Children's Hospital of Buffalo, N.Y.; Lona Sandon, R.D., assistant professor of clinical nutrition, University of Texas Southwestern Medical Center at Dallas; August 2014, Pediatrics

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