Academic journal article Childhood Obesity

Comparison of a Condensed 12-Week Version and a 24-Week Version of a Family-Based Pediatric Weight Management Program

Academic journal article Childhood Obesity

Comparison of a Condensed 12-Week Version and a 24-Week Version of a Family-Based Pediatric Weight Management Program

Article excerpt

[Author Affiliation]

Meredith L. Dreyer Gillette. 1 Department of Pediatrics, Developmental and Behavioral Sciences, Children's Mercy Kansas City, Kansas City, MO. 2 Department of Pediatrics, Weight Management, Children's Mercy Kansas City, Kansas City, MO. 3 Center for Children's Healthy Lifestyles & Nutrition, Kansas City, MO.

Cathleen Odar Stough. 3 Center for Children's Healthy Lifestyles & Nutrition, Kansas City, MO. 4 Clinical Child Psychology Program, University of Kansas, Lawrence, KS.

Cora M. Best. 2 Department of Pediatrics, Weight Management, Children's Mercy Kansas City, Kansas City, MO.

Amy R. Beck. 1 Department of Pediatrics, Developmental and Behavioral Sciences, Children's Mercy Kansas City, Kansas City, MO. 2 Department of Pediatrics, Weight Management, Children's Mercy Kansas City, Kansas City, MO.

Sarah E. Hampl. 1 Department of Pediatrics, Developmental and Behavioral Sciences, Children's Mercy Kansas City, Kansas City, MO. 2 Department of Pediatrics, Weight Management, Children's Mercy Kansas City, Kansas City, MO. 3 Center for Children's Healthy Lifestyles & Nutrition, Kansas City, MO.

Address correspondence to: Meredith L. Dreyer Gillette, PhD, Assistant Professor of Pediatrics, UMKC School of Medicine, Children's Mercy Kansas City, 2401 Gillham Road, Kansas City, MO 64108, E-mail: mldreyer@cmh.edu

Introduction

Nearly 32% of children and adolescents in the United States are considered overweight, with a BMI above the 85th percentile.1 Further, approximately 17% of children and adolescents in the United States have a BMI that is at or above the 95th percentile.1 Given this high prevalence of pediatric obesity, development of weight management interventions has been an important focus. In 2007, a multidisciplinary expert committee consisting of leaders from 15 major professional organizations was established to develop best practices for pediatric obesity assessment, prevention, and treatment.2 The expert committee recommended four stages of treatment, with the first two designed to occur within the primary care office. Stage 1, Prevention Plus, involves more-frequent follow-up visits between the primary care provider (PCP) and the family to set joint goals with the aim of improving health behaviors. If, after 3-6 months, adequate progress has not been made, the child and family would move to stage 2, Structured Weight Management, which involves monthly follow-ups and the addition of either nutrition, behavioral health, or exercise support. Stage 3, Comprehensive Multidisciplinary Intervention, is designed for children and families who have not been successful in the primary care setting, and it involves multiple treatment components, including medical management, nutrition, physical activity (PA), and behavioral health support. Family-based group treatment programs are an example of a Stage 3 treatment, which have the most empirical support. Stage 4, Tertiary Care Intervention, includes bariatric surgery, very-low-calorie diets, and medication management and is reserved for adolescents with the most medical comorbidities.

Stage 3 treatment is comprehensive and multidisciplinary, which should include behavior modification techniques (e.g., self-monitoring, goal setting, and contingency management), achieving a negative energy balance through changes to both PA and diet, and repeated evaluation of health measures (e.g., BMI) and health habits (e.g., diet and PA). In addition, the presence of a multidisciplinary team, including professionals such as psychologists, social workers, dietitians, and PCPs with experience in treating pediatric obesity, is critical, as is parent participation.2 Comprehensive behavioral interventions of at least medium intensity have been identified as effective for children with obesity 6 years of age and older and come with minimal risk or potential for adverse side effects. …

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