Community program may help some obese kids
NEW YORK (Reuters Health) - Heavy kids who took part in a program hosted at community YMCAs were able keep off some extra weight and improved their quality of life, including relationships with peers and functioning at school.
The six-month program - covering diet, physical activity and "screen time" - was a scaled-down version of intensive, clinic-based treatments that have been shown to help obese kids lose weight but at a steep price.
Researchers hope making such interventions cheaper and more convenient means many more families could benefit. But it's been unclear if a less-intensive program would still be effective at helping kids and their families make significant lifestyle changes.
"Despite the high prevalence of childhood obesity, if you're a parent of an obese child, the available treatment programs are few and far between," said Gary Foster, from Temple University in Philadelphia.
The Centers for Disease Control and Prevention estimate that 17 percent of U.S. kids and teens are now obese. Heavy kids are more likely to become heavy adults, which puts them at risk for diabetes, heart disease and a range of other weight-related conditions.
Obesity also disproportionately affects minority children and those from lower-income families - another reason why finding low-cost treatments is a priority.
Foster led the new study along with YMCA of Greater Providence, Rhode Island, with funding from United Health Group. The 155 participants were kids ages six to 17, all in the 85th percentile or higher for body size.
Together with their parents, kids went to 12 face-to-face sessions at YMCAs, which included weigh-ins and discussions on monitoring food and exercise and setting weight and behavior goals. Parents led another 12 sessions for their kids at home with the help of worksheets provided by the YMCA and phone check-ins.
Kids and teens got points for achieving their goals during the study, which they could then exchange for small prizes, such as a Frisbee.
The majority of kids and their parents - 84 percent - stuck it out through the six-month program.
Though kids and teens were still growing and on average gained both height and weight, they tended to inch closer to normal weight for their age during the program. For example, 92 percent qualified as obese at the start of the study, which dropped to 82 percent by six months out.
Kids also rated their quality of life as higher after the program on physical, emotional, social and school-related scales. Before starting the sessions, their health-related quality of life was comparable to kids with cancer, the researchers reported this week in Pediatrics.
Foster pointed out that the program didn't use specialized experts such as child psychologists and that the YMCA group leaders hadn't had any prior experience treating childhood obesity. That's what makes the findings especially promising, he told Reuters Health.
"We really tried to streamline the program to take the best of what has been shown to be effective," Foster said.
The next step, he added, will be to see if researchers can tinker with the program further to make it even simpler, so it's more convenient for families and possibly cheaper to administer.
Two of the researchers are employed by United Health Group and two others, including Foster, are consultants to the health care and insurance company.
One limitation with the study, they noted, is they didn't have information on kids' weight after six months. So they can't be sure that any obesity-related program benefits held up over the long run. There also wasn't a group of kids who didn't go through the program for researchers to track as a comparison.
Melissa Kalarchian, a psychologist and obesity researcher at the University of Pittsburgh School of Medicine who wasn't involved in the new study, agreed it begs a more systematic follow-up to explore those issues.
She told Reuters Health the current findings are "exciting" because they show taking evidence-based treatment components to the community can work.
"I think it's promising as being among the first studies to show that treatments that have been effective in a research setting can be translated into a real-world setting like the Y," Kalarchian said.
SOURCE: bit.ly/QENfoo Pediatrics, online September 17, 2012.
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