Childhood Obesity Treatment: A Maintenance Approach
Condition: Childhood Overweight; Childhood Obesity
MeSH terms: Obesity; Overweight; Pediatric Obesity
Study type: Interventional

Summary: 
      The purpose of this study is to determine the effect of dose and content of an enhanced
      weight maintenance treatment on children's ability to maintain weight loss following a
      standard weight loss treatment.
    

Detailed description: 
      Childhood Obesity (CO) prevalence in the United States has tripled in recent decades, and
      nearly 30% of children aged 6 to 11 are overweight or obese. CO is a serious public health
      problem, and is associated with both immediate and long-term health problems (e.g.,
      hypertension, type 2 diabetes, asthma) and psychosocial problems (e.g., social isolation,
      depression, eating disorder symptomatology). Furthermore, CO is a significant risk factor for
      adult obesity with several prospective studies showing that, if untreated, about half of
      overweight grade-school children remain obese as adults. Fortunately, children respond
      favorably to family-based behavioral weight loss treatment (FBT), the most well-established
      intervention for the treatment of overweight in children 7 to 12 years old. Weight loss
      treatments for overweight children have been associated with significant physical and
      psychosocial health benefits; however, despite initial success with lifestyle interventions,
      considerable relapse often occurs once treatment ends. Clearly, CO is a significant public
      health problem, and long-term maintenance of weight loss remains a priority to stem the
      increased costs to the individual and society. Therefore, we propose to conduct a multi-site
      randomized controlled trial with overweight children (N=241) and their parents (N=241) [for a
      total N=482]. All participants will complete 4 months of FBT and then be randomized to one of
      three, 8-month maintenance conditions: (1) Weight Maintenance Therapy, who will receive SFM -
      Low Dose [LOW] (16 sessions over 8 months), (2) Intensive Weight Maintenance Therapy, who
      will receive SFM - High Dose [HIGH] (32 sessions over 8 months), or (3) Current Standard of
      Care, who will receive Weight Maintenance Education (16 sessions over 8 months). Relative
      weight and associated outcomes will be assessed at 0 (pre-weight loss), 4 (post-weight loss),
      12 (post-maintenance treatment),18 months and 24 months. Additionally, brief assessments will
      be conducted at four points during the course of maintenance treatment to measure presumed
      mediators.
    

Intervention name(s): SFM+ Low Dose; Weight Maintenance Education; SFM+ High Dose
Intervention type(s): Behavioral; Behavioral; Behavioral
Intervention description(s): The SFM intervention assumes people need a social environment that supports changes in eating and physical activity for continued weight maintenance. Therefore, the SFM intervention will focus on helping families create a social environment that supports weight maintenance (e.g., children being friends with physically active peers). Participants in this group will meet less often than families that receive the Social Facilitation Maintenance (SFM) - High Dose intervention, giving them more opportunities to practice new skills between clinic visits.; The Weight Maintenance Education intervention will help participants in parent and child groups to learn more about healthy eating and physical activity in a group setting. Participants will also learn about exercise and exercise safety, hydration during exercise, and stress management. Parent and child groups will combine for particular on-site and off-site activities, such as cooking demonstrations, grocery store tours, gym tours, and dance lessons.; The SFM intervention assumes people need a social environment that supports changes in eating and physical activity for continued weight maintenance. Therefore, the SFM intervention will focus on helping families create a social environment that supports weight maintenance (e.g., children being friends with physically active peers). Participants in this group will meet more often than families that receive the Social Facilitation Maintenance (SFM) - Low Dose intervention, allowing for more in-depth discussion and practice of key skills and concepts related to creating a social environment that supports a healthy lifestyle. These participants will receive more feedback and reinforcement from fellow group members, family interventionists, and group leaders for practicing their new behaviors.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: Weight loss maintenance