Is self-help the secret to reducing childhood obesity?

By Bonnie Rochman

There is no shortage of strategies to lose weight, but which work best for children?

One in three U.S. kids weighs too much, according to the latest government statistics, but parents don’t have too many appealing options when it comes to helping their children slim down. The gold standard treatment for childhood obesity that’s typically endorsed by weight-loss specialists involves six months of weekly clinic visits lasting 90 minutes each during which families learn the basics of nutrition and are introduced to ideas such as  ”stimulus control” — or bringing only healthy food into their homes lessen the temptation from more calorie-ridden, unhealthy products. But many parents can’t afford the time or money that requires.

Now researchers from the University of California, San Diego (UCSD) say parents can help their kids lose weight without such costly and time-consuming intervention by relying on a self-help “coaching” method that requires only bi-weekly guidance from a pediatrician. In a study published in the journal Pediatrics, the scientists found that using the self-help model resulted in a 12-year-old of average height losing five pounds over the five-month study period compared to children who received no guidance about weight loss. Those kids who got no treatment during the study period actually gained weight: a 12-year-old of average height put on five pounds. “We saw significant losses in the guided self-help kids while the control group continued to gain weight,” says Kerri Boutelle, lead author and a professor of pediatrics and psychiatry at UCSD.

The more flexible approach — which reduced face-to-face treatment time from about 36 hours over six months to less than five hours over five months — could potentially help more families and broaden the reach of childhood-obesity treatment, say the study authors. “This is the first time this kind of model has been tested and it looks promising,” says Boutelle.

Fifty families with overweight or obese children between the ages of 8 and 12 participated in the study, with the kids and parents divided into two groups: one took part in the five-month guided self-help program while the other received no specific weight-loss treatment during that time.

As part of the program, the parents and children learned about the importance of eating healthy foods and exercising regularly; parents were taught how to set limits and instruct their kids to monitor their own eating by recording everything they ate in a “habit book.” Every two weeks, the families visited their physicians for 20 minutes. At these appointments, the children were weighed and the families were given advice on how to navigate stumbling blocks. The doctors also assigned the children and parents reading material that articulated the same behavior-changing skills provided in the more time-intensive treatment. “It’s not real therapy,” says Boutelle. “It’s more like coaching.”

The idea behind the self-help protocol was to help pediatricians, not weight-loss specialists, initiate and oversee efforts to help heavier children lose weight. Since pediatricians have the most contact with children and their families, they’re likely to be the physicians who first identify a child as obese.

In a second phase of the study, the kids who received no treatment during the initial stages were provided with the self-help guidance. Their weight-loss results were combined with the initial group and on average, all of the children lost one body-mass index (BMI) point, a significant drop for most children, even if the exact number of pounds lost varied from child to child. “Losing five pounds in an 8-year-old is a lot more than losing five pounds in a 12-year-old,” says Boutelle.

Boutelle is especially encouraged that all of the children lost weight while using the self-help program and plans to test the curriculum on a larger scale in primary-care clinics. Offering pediatricians a relatively easy-to-implement program for weight loss could prompt more doctors to discuss obesity with their patients and provide them with a practical solution as well. “Pediatricians are really good at giving nutrition and physical activity advice, but parents often ask, How am I supposed to make this happen?” says Boutelle. “We’ve created a method for pediatricians to do this in short visits.” And those short-term investments could translate into long-term health benefits for kids.

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