PARENTS AS THE EXCLUSIVE AGENTS OF CHANGE IN THE TREATMENT OF CHILDHOOD OBESITY

Background: Excessive weight in childhood is a serious public health c oncern because of its costly health consequences and its increasing pr evalence. Objective: Our objective was to compare the efficacy of a fa mily-based approach for the treatment of childhood obesity, in which t he parents served as the exclusive agents of change, with that of the conventional approach, in which the children served as the agents of c hange. Design: This study had a randomized, longitudinal prospective d esign and lasted 1 y. Sixty obese children aged 6-11 y were randomly a llocated to the experimental (parents as agents of change) or control (children as agents of change) group. Anthropometric and biochemical m easurements were determined at the start and end of the study. A socio demographic questionnaire and a family eating and activity habits ques tionnaire were completed by both parents. Hour-long support and educat ional sessions were conducted by a clinical dietitian: 14 sessions for the parents in the experimental group and 30 sessions for the childre n in the control group. Results: The dropout rate was nine times great er in the control group (n = 9) than in the experimental group (n = 1) . Mean percentile weight reduction was significantly (P < 0.03) higher in children in the experimental group (14.6%) than in the control gro up (8.1%). Conclusions: Treatment of childhood obesity with parents as the exclusive agents of change was superior to the conventional appro ach, as indicated by the dropout rate and the percentage weight loss o f the children during the 1-y intervention.