Abstract
Background:
The best outcomes for treating childhood obesity have come from comprehensive family-based programmes. However there are questions over their generalizability.
Objective:
To examine the acceptability and effectiveness of ‘family-based behavioural treatment’ (FBBT) for childhood obesity in an ethnically and socially diverse sample of families in a UK National Health Service (NHS) setting.
Methods:
In this parallel group, randomized controlled trial, 72 obese children were randomized to FBBT or a waiting-list control. Primary outcomes were body mass index (BMI) and BMI s.d. scores (SDSs). Secondary outcomes were weight, weight SDSs, height, height SDSs, waist, waist SDSs, FM index, FFM index, blood pressure (BP) and psychosocial measures. The outcomes were assessed at baseline and after treatment, with analyses of 6-month data performed on an intent-to-treat (ITT) basis. Follow-up anthropometric data were collected at 12 months for the treatment group.
Results:
ITT analyses included all children with baseline data (n=60). There were significant BMI SDS changes (P<0.01) for the treatment and control groups of −0.11 (0.16) and −0.10 (1.6). The treatment group showed a significant reduction in systolic BP (−0.24 (0.7), P<0.05) and improvements in quality of life and eating attitudes (P<0.05), with no significant changes for the control group. However the between-group treatment effects for BMI, body composition, BP and psychosocial outcomes were not significant. There was no overall change in BMI or BMI SDSs from 0–12 months for the treatment group. No adverse effects were reported.
Conclusions:
Both treatment and control groups experienced significant reductions in the level of overweight, but with no significant difference between them. There were no significant group differences for any of the secondary outcomes. This trial was registered at http://www.controlled-trials.com/ under ISRCTN 51382628.
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Acknowledgements
We thank the families who took part, and the clinical and administrative staff at Great Ormond Street Hospital and the research staff at UCL for contributing their time and effort to the study. The trial was funded by Cancer Research UK, Great Ormond Street Hospital and Weight Concern. All authors contributed to the study design and protocol. JW obtained the funding for the study. HC was responsible for the day-to-day running of the study and for recruitment; supervised the running of treatment sessions and clinical staff; analysed the data; interpreted the results and drafted the paper. RMV was responsible for the medical assessment and care of children, and analysed data and interpreted the results. DN had overall clinical responsibility for families, analysed data and interpreted the results. DH performed the body composition and anthropometric measurements. PC and CE contributed to the supervision of treatment sessions and clinical staff. JCKW provided the protocol and facilities for the body composition measures. All authors reviewed the manuscript. JW is the guarantor.
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Croker, H., Viner, R., Nicholls, D. et al. Family-based behavioural treatment of childhood obesity in a UK national health service setting: randomized controlled trial. Int J Obes 36, 16–26 (2012). https://doi.org/10.1038/ijo.2011.182
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DOI: https://doi.org/10.1038/ijo.2011.182
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