Academic journal article Childhood Obesity

Warm Parenting Associated with Decreasing or Stable Child BMI during Treatment

Academic journal article Childhood Obesity

Warm Parenting Associated with Decreasing or Stable Child BMI during Treatment

Article excerpt

[Author Affiliation]

Kyung E. Rhee. 1 Center for Healthy Eating and Activity Research, Department of Pediatrics, University of California, San Diego, School of Medicine, La Jolla, CA.

Elissa Jelalian. 2 Department of Pediatrics, Brown University Medical School, Providence, RI. 4 Department of Psychiatry and Human Behavior, Brown University Medical School, Providence, RI. 6 Weight Control and Diabetes Research Center, Providence, RI.

Kerri Boutelle. 1 Center for Healthy Eating and Activity Research, Department of Pediatrics, University of California, San Diego, School of Medicine, La Jolla, CA. 3 Department of Psychiatry, University of California, San Diego, School of Medicine, La Jolla, CA.

Susan Dickstein. 4 Department of Psychiatry and Human Behavior, Brown University Medical School, Providence, RI.

Ronald Seifer. 4 Department of Psychiatry and Human Behavior, Brown University Medical School, Providence, RI. 5 Bradley Hasbro Children's Research Center, Providence, RI.

Rena Wing. 2 Department of Pediatrics, Brown University Medical School, Providence, RI. 4 Department of Psychiatry and Human Behavior, Brown University Medical School, Providence, RI. 6 Weight Control and Diabetes Research Center, Providence, RI.

Address correspondence to: Kyung E. Rhee, MD, MSc, MA, University of California, San Diego, School of Medicine, Division of Academic General Pediatrics, Developmental Pediatrics, and Community Health, Center for Healthy Eating and Activity Research, 9500 Gilman Drive, MC 0874, La Jolla, CA 92093, E-mail: K1rhee@ucsd.edu

Introduction

Currently, 33.2% of children age 6 to 19 years are overweight or obese (BMI ≥85th percentile).1 Obesity in childhood is highly correlated with adult obesity,2 and leads to higher risk of obesity-related comorbidities such as cardiovascular disease,3 diabetes mellitus,4 and cancer.5 The current gold standard treatment for childhood obesity is family-based behavioral therapy (FBT),6 which includes nutrition and physical activity education for parents and children, along with behavior therapy skills such as monitoring, goal setting, problem solving, stimulus control, and modeling.7-9 Despite its overall success, not all children respond to FBT. Studies demonstrate large variability in short-term outcomes,10-12 with only a third of children being able to maintain their weight status and another third increasing 20% or more from their baseline percent overweight at 10-year follow-up.13

Since parents are responsible for structuring the home eating and physical activity environment, parent involvement in FBT is crucial.14,15 Studies comparing parent-focused interventions to child-focused interventions (for children age 6 to 11 years) show greater reduction in child percent overweight when parents are targeted as the agent of change (14.6% vs. 8.4%).16,17 Furthermore, parent-only programs that require parents to master weight control strategies and deliver it to their children (ranging in age from 8 to 14 years), without their child attending the treatment program, are equally effective as programs that involve both parent and child.18,19

Despite the importance of parents, little is known about how parents are contributing to their child's ability to decrease weight status during weight loss treatment. At a broader level, studies have shown that social risk factors like parent education and employment status are associated with a child's ability to lose weight; families with higher social risk are less likely to have children who lose weight.20 On a behavioral level, parents who successfully lose weight are more likely to have children (age 8 to 12 years) who can decrease their BMI or BMI z-score (BMI-Z). …

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