To assess a 2-year family-based behavioural intervention programme against child obesity.
Single-group pre- and post-intervention feasibility study.
Swedish paediatric outpatient care.
26 obese children aged 8.3–12.0 years and their parents who had consented to actively participate in a 2-year intervention.
25 paediatric outpatient group sessions over a 2-year period with parallel groups for children and parents. The basis for the programme was a manual containing instructions for tutor-supervised group sessions with obese children and their parents.
Primary and secondary outcome measures
The primary outcome measure was change in standardised body mass index between baseline and after 36 months. The secondary outcome measures were change in the waist:height ratio, metabolic parameters and programme adherence. The participants were examined at baseline and after 3, 12 and 24 months of therapy and at follow-up 12 months after completion of the programme.
The primary outcome measure, standardised body mass index, declined from a mean of 3.3 (0.7 SD) at baseline to 2.9 (0.7 SD) (p<0.001) at follow-up 12 months after completion of the programme. There was no change in the waist:height ratio. Biomedical markers of blood glucose metabolism and lipid status remained in the normal range. 96% of the families completed the programme.
This feasibility study of a 2-year family-based behavioural intervention programme in paediatric outpatient care showed promising results with regard to further weight gain and programme adherence. These findings must be confirmed in a randomised controlled trial with longer follow-up before the intervention programme can be implemented on a larger scale.
Family-based behavioural interventions have produced promising results in controlled studies, but their effectiveness in paediatric outpatient settings remains to be shown.
A 2-year family-based behavioural intervention programme for the management of childhood obesity in paediatric outpatient care showed promising results with regard to weight gain 1 year after the programme.
The completion rate of the programme was high, which is important as high family adherence is a success factor for childhood obesity therapy.
Strengths and limitations of this study
The main methodological strengths of this study are that the primary end point measurement was performed 12 months after completion of the long-term intervention programme and that all participants were included in the data analysis at the study end point whether or not they had completed the intervention.
The major weaknesses of the study are the small study sample and single-group design. The design implies that the observed decline in standardised body mass index cannot be firmly interpreted as an effect of the intervention programme. The results would have been even more convincing if all the secondary outcome measures had displayed similar trends. Longer follow-up than 12 months is necessary to examine sustainable effects of the intervention.