Reducing variety enhances effectiveness of family-based treatment for pediatric obesity

Abstract

Basic research has shown that increasing variety increases energy intake, and repeated consumption of the same food increases habituation to those foods and reduces consumption. Twenty-four families with overweight/obese 8-12 year-old children and overweight/obese parents were randomly assigned to 6months of usual family based treatment (FBT) or FBT plus reduced variety of high energy-dense foods (FBT+Variety). Intention to treat mixed model ANOVA showed between group differences in child percent overweight (FBT+Variety-15.4% vs. FBT-8.9%, p=0.017) and parent BMI (FBT+Variety-3.7kg/m(2) vs. FBT-2.3kg/m(2); p=0.017). Positive relationships were observed between child zBMI and parent BMI changes (r=0.51, p=0.018), and between reductions in food variety of high energy-dense foods and reductions in child zBMI (r=0.54, p=0.02) and parent BMI (r=0.45, p=0.08). These pilot data suggest that reducing the variety of high energy dense foods and repeating meals within the context of FBT resulted in improved child and parent weight changes at six months. This represents easy to implement changes that reduce choice and may reduce response burden on families. Reducing variety may be a complement to standard FBT that enhances weight loss. Long term studies are needed to assess maintenance of these changes.

Trial registration: ClinicalTrials.gov NCT01208870.

Keywords: Habituation; Pediatric obesity; Variety.

Figure 1

Changes in child percent overweight and parent BMI over six months by group. Mixed model ANCOVA controlling for baseline values showed greater reductions of child percent overweight for the FBT+Variety group from 0–6 months (FBT+Variety=−15.4% vs. FBT=−8.9%; t(270) = 2.40, p = 0.02), as well as greater reductions in parent BMI (FBT+Variety −3.7 kg/m² vs. FBT −2.3 kg/m²; t(265) = 2.40, p = 0.02).