Pediatric Weight Management

PWM: Behavioral Interventions Targeting Parents (2006)

There are a number of types of behavioral training for parents used in treating childhood overweight. At this point we have examined the research on parental modeling.

• Intervention
  What is the effectiveness of family-based counseling including parent training or modeling as part of a multicomponent pediatric weight management program to treat obesity in children (ages 6-12)?

  • Conclusion

    Using family-based counseling including parent training or modeling as part of a multi-component pediatric weight management program results in significant reductions in weight status and adiposity in children 12 years and younger.

  • Grade: I
    • Grade I means there is Good/Strong evidence supporting the statement;
    • Grade II is Fair;
    • Grade III is Limited/Weak;
    • Grade IV is Expert Opinion Only;
    • Grade V is Not Assignable.
    • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
    • Moderate (B) means we are moderately confident in the effect estimate;
    • Low (C) means our confidence in the effect estimate is limited;
    • Very Low (D) means we have very little confidence in the effect estimate.
  • Evidence Summary: Parent training or modeling as a part of an intervention program to treat childhood obesity
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Brown R, Sothern M, Suskind R, Udall J, Blecker U. Racial differences in the lipid profiles of obese children and adolescents before and after significant weight loss. Clinical Pediatrics 2000; 39: 427-431.
      • Brownell KD, Kelman JH, Stunkard AJ. Treatment of obese children with and without their mothers: changes in weight and blood pressure. Pediatrics 1983; 71: 515-23.
      • Chen W, Chen SC, Hsu HS, Lee C. Counseling clinic for pediatric weight reduction: program formulation and follow-up. J Formos Med Assoc 1997; 96 59-62.
      • Coates TJ, Killen JD, Slinkard LA. Parent participation in a treatment program for overweight adolescents. Int J Eat Disord 1982; 1: 37-48.
      • de Mello ED, Luft VC, Meyer F. Individual outpatient care versus group education programs. Which leads to greater change in dietary and physical activity habits for obese children? J Pediatr (Rio J). 2004 Nov-Dec;80(6):468-74.
      • Epstein LH, Paluch RA, Gordy CC, Dorn J. Decreasing sedentary behaviors in treating pediatric obesity. Arch Pediatr Adolesc Med 2000; 154 (3):220-6.
      • Epstein LH, Paluch RA, Gordy CC, Saelens BE, Ernst MM. Problem solving in the treatment of childhood obesity.  J Consult Clin Psychol 2000;68:717-21.
      • Epstein LH, Paluch RA, and Raynor HA. Sex Differences in Obese Children and Siblings in Family-based Obesity Treatment. Obesity Research 2001;9:746-753 
      • Epstein LH, Valoski A, Wing RR, McCurley J. Ten-year follow-up of behavioral, family-based treatment for obese children. JAMA 1990; 264: 2519-2523.
      • Epstein LH, Valoski A, Wing RR, McCurley J. Ten-year outcomes of behavioral family-based treatment for childhood obesity. Health Psychology. 1994, 13:373-383.
      • Epstein LH, Valoski AM, Vara LS, McCurley J, Wisniewski L, Kalarchian MA, Klein KR, Shrager LR. Effects of decreasing sedentary behavior and increasing activity on weight change in obese children.  Health Psychol 1995;14:109-15.
      • Epstein LH, Wing RR, Koeske R, and Valoski A. Effect of parent weight on weight loss in obese children.  Journal of Consulting and Clinical Psychology.  54(3):  400-401, 1986.
      • Epstein LH, Wing RR, Koeske R, Valoski A. Effects of diet plus exercise on weight change in parents and children. Journal of Consulting and Clinical Psychology 1984; 52:429-437.
      • Epstein LH, Wing RR, Koeske R, Valoski A. A Comparison of Lifestyle Exercise, Aerobic Exercise, and Calisthenics on Weight Loss in Obese Children. Behavior Therapy 1985;16;345-56.
      • Epstein LH, Wing RR, Penner BC, Kress MJ. Effect of diet and controlled exercise on weight loss in obese children.  J Pediatr 1985;107:358-61.
      • Epstein, L, Valoski A, Kalarchian M, et al. Do children lose and maintain weight easier than adults: a comparison of child and parent weight changes from six months to ten years. Obes Res 1995; 3:411-417.
      • Flodmark CE, Ohlsson T, Ryden O, Sveger T. Prevention of progression to severe obesity in a group of obese schoolchildren treated with family therapy. Pediatrics 1993; 91: 880-84.
      • Golan M, Weizman A, Apter A, Fainaru M. Parents as the exclusive agents of change in the treatment of childhood obesity. Am J Clin Nutr 1998;67:1130-1135.
      • Israel AC, Guile CA, Baker JE. An evaluation of enhanced self-regulation training in the treatment of childhood obesity. J Pediatr Psychol 1994; 19:737-49.
      • Kirschenbaum DS, Harris ES, Tomarken AJ. Effects of parental involvement in behavioral weight loss therapy for preadolescents. Behavior Therapy 1984;15:485-500. 
      • Levine, M., Ringham, R., Kalarchian, M., Wisniewski, L., and Marcus, M. Is family-based behavioral weight control appropriate for severe pediatric obesity? Int J Eat Disord. 2001 Nov;30(3):318-28.
      • Miraglia del Giudice E, Santoro N, Marotta A, Nobili B, Di Toro, Perrone L. Inadequate leptin level negatively affects body fat loss during a weight reduction programme for childhood obesity. Acta Paediatr 2002; 91: 132-135.
      • Sothern, M., Hunter, S., Suskind R., Brown, R., Udall, J. and Blecker, U. Motivating the obese child to move: the role of structured exercise in pediatric weight management. Southern Medical Journal 1999; 92: 577-584.
      • Sothern, M., Despinasse, B., Brown, R., Suskind, R., Udall, J. and Blecker, U. Lipid profiles of obese children and adolescents before and after significant weight loss: differences according to sex. Southern Medical Journal 2000; 93: 278-282.
      • Sothern, M., Loftin, M., Udall, J., Suskind R., Ewing, T., Tang, S., & Blecker, U. Safety, feasibility and efficacy of a resistance training program in preadolescent obese children. American Journal of the Medical Sciences, 2000; 319: 370-375. 
      • Sothern, M., Schumacher, H., von Almen, T., Carlisle, L., & Udall, J. Committed to Kids: an integrated, four level team approach to weight management in adolescents. Journal of the American Dietetic Association 2002;102:S81-S85.
      • Sothern, M., Udall, J. Suskind, R., Vargas, A., & Blecker, U. Weight loss and growth velocity in obese children after very low calorie diet, exercise and behavior modification. Acta Paediatrica, 2000; 89(9): 1036-43.
      • Wadden, T., Stunkard, A., Rich, L., Rubin, C., Sweidel, G, McKinney, S. Obesity in black adolescent girls: a controlled clinical trial of treatment by diet, behavior modification, and parental support. Pediatrics. 1990, 85(3): 345-352.
  • Search Plan and Results: Behavioral Interventions for Pediatric Weight Management 2005
     
  What is the effectiveness of family-based counseling including parent training or modeling as part of a multicomponent pediatric weight management program to treat obesity in adolescents (ages 13-18)?

  • Conclusion

    Including parent training or modeling as part of a multicomponent program to treat adolescent obesity is associated with improvement in adiposity.

  • Grade: II
    • Grade I means there is Good/Strong evidence supporting the statement;
    • Grade II is Fair;
    • Grade III is Limited/Weak;
    • Grade IV is Expert Opinion Only;
    • Grade V is Not Assignable.
    • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
    • Moderate (B) means we are moderately confident in the effect estimate;
    • Low (C) means our confidence in the effect estimate is limited;
    • Very Low (D) means we have very little confidence in the effect estimate.
  • Evidence Summary: Parent training or modeling as a part of an intervention program to treat childhood obesity
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Brown R, Sothern M, Suskind R, Udall J, Blecker U. Racial differences in the lipid profiles of obese children and adolescents before and after significant weight loss. Clinical Pediatrics 2000; 39: 427-431.
      • Brownell KD, Kelman JH, Stunkard AJ. Treatment of obese children with and without their mothers: changes in weight and blood pressure. Pediatrics 1983; 71: 515-23.
      • Chen W, Chen SC, Hsu HS, Lee C. Counseling clinic for pediatric weight reduction: program formulation and follow-up. J Formos Med Assoc 1997; 96 59-62.
      • Coates TJ, Killen JD, Slinkard LA. Parent participation in a treatment program for overweight adolescents. Int J Eat Disord 1982; 1: 37-48.
      • de Mello ED, Luft VC, Meyer F. Individual outpatient care versus group education programs. Which leads to greater change in dietary and physical activity habits for obese children? J Pediatr (Rio J). 2004 Nov-Dec;80(6):468-74.
      • Epstein LH, Paluch RA, Gordy CC, Dorn J. Decreasing sedentary behaviors in treating pediatric obesity. Arch Pediatr Adolesc Med 2000; 154 (3):220-6.
      • Epstein LH, Paluch RA, Gordy CC, Saelens BE, Ernst MM. Problem solving in the treatment of childhood obesity.  J Consult Clin Psychol 2000;68:717-21.
      • Epstein LH, Paluch RA, and Raynor HA. Sex Differences in Obese Children and Siblings in Family-based Obesity Treatment. Obesity Research 2001;9:746-753 
      • Epstein LH, Valoski A, Wing RR, McCurley J. Ten-year follow-up of behavioral, family-based treatment for obese children. JAMA 1990; 264: 2519-2523.
      • Epstein LH, Valoski A, Wing RR, McCurley J. Ten-year outcomes of behavioral family-based treatment for childhood obesity. Health Psychology. 1994, 13:373-383.
      • Epstein LH, Valoski AM, Vara LS, McCurley J, Wisniewski L, Kalarchian MA, Klein KR, Shrager LR. Effects of decreasing sedentary behavior and increasing activity on weight change in obese children.  Health Psychol 1995;14:109-15.
      • Epstein LH, Wing RR, Koeske R, and Valoski A. Effect of parent weight on weight loss in obese children.  Journal of Consulting and Clinical Psychology.  54(3):  400-401, 1986.
      • Epstein LH, Wing RR, Koeske R, Valoski A. Effects of diet plus exercise on weight change in parents and children. Journal of Consulting and Clinical Psychology 1984; 52:429-437.
      • Epstein LH, Wing RR, Koeske R, Valoski A. A Comparison of Lifestyle Exercise, Aerobic Exercise, and Calisthenics on Weight Loss in Obese Children. Behavior Therapy 1985;16;345-56.
      • Epstein LH, Wing RR, Penner BC, Kress MJ. Effect of diet and controlled exercise on weight loss in obese children.  J Pediatr 1985;107:358-61.
      • Epstein, L, Valoski A, Kalarchian M, et al. Do children lose and maintain weight easier than adults: a comparison of child and parent weight changes from six months to ten years. Obes Res 1995; 3:411-417.
      • Flodmark CE, Ohlsson T, Ryden O, Sveger T. Prevention of progression to severe obesity in a group of obese schoolchildren treated with family therapy. Pediatrics 1993; 91: 880-84.
      • Golan M, Weizman A, Apter A, Fainaru M. Parents as the exclusive agents of change in the treatment of childhood obesity. Am J Clin Nutr 1998;67:1130-1135.
      • Israel AC, Guile CA, Baker JE. An evaluation of enhanced self-regulation training in the treatment of childhood obesity. J Pediatr Psychol 1994; 19:737-49.
      • Kirschenbaum DS, Harris ES, Tomarken AJ. Effects of parental involvement in behavioral weight loss therapy for preadolescents. Behavior Therapy 1984;15:485-500. 
      • Levine, M., Ringham, R., Kalarchian, M., Wisniewski, L., and Marcus, M. Is family-based behavioral weight control appropriate for severe pediatric obesity? Int J Eat Disord. 2001 Nov;30(3):318-28.
      • Miraglia del Giudice E, Santoro N, Marotta A, Nobili B, Di Toro, Perrone L. Inadequate leptin level negatively affects body fat loss during a weight reduction programme for childhood obesity. Acta Paediatr 2002; 91: 132-135.
      • Sothern, M., Hunter, S., Suskind R., Brown, R., Udall, J. and Blecker, U. Motivating the obese child to move: the role of structured exercise in pediatric weight management. Southern Medical Journal 1999; 92: 577-584.
      • Sothern, M., Despinasse, B., Brown, R., Suskind, R., Udall, J. and Blecker, U. Lipid profiles of obese children and adolescents before and after significant weight loss: differences according to sex. Southern Medical Journal 2000; 93: 278-282.
      • Sothern, M., Loftin, M., Udall, J., Suskind R., Ewing, T., Tang, S., & Blecker, U. Safety, feasibility and efficacy of a resistance training program in preadolescent obese children. American Journal of the Medical Sciences, 2000; 319: 370-375. 
      • Sothern, M., Schumacher, H., von Almen, T., Carlisle, L., & Udall, J. Committed to Kids: an integrated, four level team approach to weight management in adolescents. Journal of the American Dietetic Association 2002;102:S81-S85.
      • Sothern, M., Udall, J. Suskind, R., Vargas, A., & Blecker, U. Weight loss and growth velocity in obese children after very low calorie diet, exercise and behavior modification. Acta Paediatrica, 2000; 89(9): 1036-43.
      • Wadden, T., Stunkard, A., Rich, L., Rubin, C., Sweidel, G, McKinney, S. Obesity in black adolescent girls: a controlled clinical trial of treatment by diet, behavior modification, and parental support. Pediatrics. 1990, 85(3): 345-352.
  • Search Plan and Results: Behavioral Interventions for Pediatric Weight Management 2005