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. 2007 Jul;26(4):381-91.
doi: 10.1037/0278-6133.26.4.381.

Family-based obesity treatment, then and now: twenty-five years of pediatric obesity treatment

Leonard H Epstein  1 , Rocco A Paluch, James N Roemmich, Meghan D Beecher
Affiliations

Family-based obesity treatment, then and now: twenty-five years of pediatric obesity treatment

Leonard H Epstein et al. Health Psychol. 2007 Jul.

Abstract

Objective: Family-based treatments for pediatric obesity were developed over 25 years ago. Over that time, youth have become more obese and the environment more obesiogenic, which may influence efficacy of pediatric weight control. Mixed-effects regression models were used to compare the efficacy of programs initiated 20 to 25 years ago to current programs through 24-month follow-up, as well as to reanalyze 10-year outcomes of previous research using contemporary measures and analytic strategies.

Main outcome measures: z-BMI and percent overweight.

Results: Results showed significant reductions over time, with no differences in z-BMI change for older versus contemporary studies. Age was a predictor of z-BMI up to 24 months, with younger children showing larger change. Mixed-effects regression models replicated previous long-term effects of family-based interventions. Gender was a predictor of long-term z-BMI change, with girls benefiting more over time than did boys.

Conclusion: The efficacy of the family-based behavioral approach to treating pediatric obesity replicates over a 25-year period. Challenges in evaluating treatment effects over time are discussed. Ideas for studying choice of treatments that vary in effect size and for strengthening family-based behavioral treatments are noted.

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Figures

Figure 1
Figure 1
z-body mass index (z-BMI) change (M ± SEM) for younger (≤ 10.33 years of age) or older (> 10.33 years of age) children in Studies 1–8.
Figure 2
Figure 2
z-body mass index (z-BMI) change (M ± SEM) for boys and girls in Studies 1–4.
Figure 3
Figure 3
Forest plot of effect sizes and 95% confidence intervals for studies that provided 6-, 12-, 24-, 60-, and 120-month follow-up.
See this image and copyright information in PMC

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