Daily Dose: Early Childhood Obesity Treatment Found Effective Long-Term

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Patient Care brings primary care clinicians a lot of medical news every day—it’s easy to miss an important study. The Daily Dose provides a concise summary of one of the website's leading stories you may not have seen.

Last week, we reported on a study published in the International Journal of Obesity that examined weight status 48 months after initiation of obesity treatment among children aged between 4 and 6 years who participated in the More and Less (ML) study, a 12-month randomized controlled trial (RCT).

The study

The ML study was conducted in Sweden between 2012 and 2017 and assessed the effects of a 10-week parent support program, with and without telephone-based booster sessions, compared to standard treatment. Among the 177 families recruited to the ML study, 6 children were excluded because of medical diagnoses, therefore, 171 families were eligible for the current modified intention-to-treat analysis.

Of the 171 families, 34 (19%) dropped out between enrollment and 48 months, 23 (13%) were lost to follow-up (eg, no contact, moved abroad), and 114 (64%) had measurements at 48 months.

The families were randomly assigned to 1 of 3 treatment options: a 10-week parent support treatment group with follow-up booster phone call sessions (PGB) or without booster sessions (PGNB), and standard outpatient treatment (ST). The primary outcome was mean difference in body mass index standard deviation score (BMI-SDS) between the parent programs and ST.

Treatment effects on the primary outcome (BMI-SDS), secondary outcomes (BMI, waist circumference [WC]), and post-hoc outcome (% International Obesity Task Force [IOTF] -25)* were assessed from baseline to 48 months.

Findings

After 48 months, investigators observed that mean BMI-SDS was reduced in all 3 groups:

• PGB: −0.45 (95% CI −0.73 to −0.18; P<.001)

• PGNB: −0.34 (95% CI −0.55 to −0.13; P<.001)

• ST: −0.25 (95% CI −0.40 to −0.10; P<.001)

Moreover, researchers found no significant difference between the groups.

Authors also noted that a clinically significant reduction of BMI-SDS ≥0.5 was reached by 53.7% of the PGB group, which was twice as likely compared to ST (33%, RR 2.03 [95% CI 1.27-3.27; P=.003]), with no difference compared to PGNB (46.6% (P=.113).

However, %IOTF25 was unchanged from baseline to 48 months for the PGB group (4.50, 95% CI −1.64-10.63), and was significantly lower compared to ST (11.92, 95% CI 8.40-15.44) (P=.043).

Authors' comment

"The intensive parent-support early childhood obesity intervention led to better weight status outcomes over time, though BMI-SDS alone did not reflect this. Further research should investigate how to assess weight changes in growing children."

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