Family Trip

Three Steps to Better Obesity Care for Kids

A new randomized, controlled trial of options for community-based childhood obesity care popped up yesterday in JAMA Pediatrics. You won’t find radical breakthroughs in it. But the study offers some solid insights about delivering better obesity care for kids. Lead author Elsie Taveras explained:

Our findings are pretty conclusive that three aspects of interventions for childhood obesity work:
• Improving clinical practices for obesity management
• Engaging and supporting families in behavior change
• Linking families to community resources for further support

Assessing the Value of Health Coaching

At the heart of this randomized trial was a key question. Could tailored health coaching help deliver better obesity care for kids? So families were randomized into two groups.

One group received enhanced obesity care (as compared with typical pediatric practices). The enhancements centered on those three principles Taveras described. These enhancements are pretty simple. Clinicians identified children with high BMI for age and gender. Decision support tools for weight management guided the clinicians. Parents engaged in the weight management process. And the providers connected families with resources in their communities that could help them sustain their progress.

The second group got all that, plus health coaching. That coaching was tailored to the family and delivered by text messages, by phone, by video chats, or in person. The choice was left to family preferences.

In the end, health coaching did not make a big difference. Just following established principles for childhood obesity care delivered healthier weights for these kids, compared to where they started. Families who received the coaching reported better quality of life for their children compared to where they started. But it fell short of showing better results than the control group.

Striving for Better Care

For kids and families dealing with obesity, pediatricians can improve health and life by following the basic principles for childhood obesity care outlined in this study. They can interrupt the natural tendency for childhood obesity to progress into adulthood.

That would be a start, but it’s still not enough. We need more options. We’re far short of the goal: helping more kids grow up with less burden from childhood obesity. That will only come with bold research and a better understanding of this disease.

Click here for the study and here for more from the researchers at Massachusetts General Hospital.

Family Trip, photograph © yáng / flickr

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June 6, 2017

2 Responses to “Three Steps to Better Obesity Care for Kids”

  1. June 06, 2017 at 10:44 pm, Allen Browne said:

    Valuable study of PCP intervention for children with overweight, obesity and severe obesity.

    Confirmed USPHSTF recommendation of 26 contact points to get any effect – intensity makes a difference

    Shows that 90% need advanced tools. Perhaps 100% for those with severe obesity.

    Shows that the more abnormal the less response.

    Emphasizes socio-environmental factors but doesn’t seem to recognize the energy management system and how it drives behavior. And that behavior maybe unhealthy. Suggests socio-environmental factors drive behavior rather than physiology driving behavior.

    Very useful to those of us exploring advanced tools for pediatric obesity. Shows consistent limitation to PCP intervention with about a 10% response rate.

    Need more age stratified and weight group stratified studies – ages 2-6, 7-12, 13-18 and overweight, obese and severe obese.

    Thanks

  2. June 07, 2017 at 4:51 am, Ted said:

    Thanks, Allen, for your well-informed insights!