Weight Loss Maintenance for Kids Benefits from Extended Intervention

ST. LOUIS, Oct. 9 -- A maintenance program emphasizing behavioral or social skills may help overweight kids keep the pounds off after a weight loss intervention, researchers found.

Post-weight-loss strategies were associated with significantly better weight maintenance through two years of follow-up than no further active treatment (P

The behavioral skills maintenance group emphasized self-regulation behaviors and strategies to prevent relapse, such as identifying and dealing with situations in which they might overeat or skip physical activity.

The social facilitation maintenance intervention taught parents to help their child incorporate physical activity and healthy eating into their social network. It also taught families to overcome weight-related teasing and body image concerns that could stand in the way of physical activity.

All weight loss and maintenance sessions consisted of 20 minutes of family treatment and 40 minutes of treatment for children and parents separately.

The weight loss intervention resulted in significant decreases in body mass index z score (mean ?0.22, P

Over the short term, this effect tended to be better with the social skills group or pooled interventions than without maintenance treatment at one year (P=0.06 and P=0.07, respectively).

But by two years of follow-up, neither intervention nor the two pooled were better than control after randomization (P=0.97, P=0.25, and P=0.50, respectively). Percentage overweight results were similar.

However, children with higher than average social problems at baseline, as measured with the parent-reported social problems subscale of the Achenbach Child Behavior Checklist, had no added benefit for weight maintenance from either of the interventions.

Children with low scores on the social problems scale had a significant benefit from the social skills maintenance intervention (P=0.008 for percentage overweight and P=0.005 for BMI z score) and from the behavioral skills intervention (P=0.05 for BMI z score) from baseline through two-year follow-up compared with controls.

"Ultimately, the environment in which these interventions are applied also must be considered," concluded Drs. Rhodes and Ludwig.

"For greatest benefit," they added, "family-based approaches to obesity should be coupled with interventions in the school and in the community, while even broader efforts focus on the ways in which food marketing can be used to promote rather than jeopardize children's health."

For data from a newly published study on prevention of obesity in childhood see "Bubble Bursts for Childhood Obesity Prevention Program."

Dr. Rhodes reported that she provides contracted clinical and administrative services for a program at the privately owned Pediatric Weight Management Centers, LLC. Dr. Ludwig reported receiving royalties from a book on childhood obesity entitled Ending the Food Fight: Guide Your Child to a Healthy Weight in a Fast Food/Fake Food World.