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M O Korppi
Dr M O Korppi, Tampere University, Tampere, Finland;
Is a group intervention for parents and children more effective than routine care for weight loss in obese school-age children?
randomised controlled trial.
6 months after the end of the intervention.
schools and a university hospital paediatric outpatient clinic in Kuopio and area, Finland.
families with an obese child 7–9 years of age (mean age 8 y, 60% girls) who attended school and had weight-for-height 120–200% (mean 142%, population mean 100%). Exclusion criteria included obesity because of disease or medication, movement disorder, mental disorder in child or parent, and family member participation in another weight management programme.
group intervention, which comprised 15 90-minute group sessions over 6 months (separate sessions for parents and children) that focused on a healthy lifestyle (diet, physical activity, and behaviour change) (n = 35); or routine care, which comprised 2 30-minute individual counselling sessions for the child, delivered by a school nurse, several months apart (n = 35). Both groups received supportive written material for parents and children.
change in weight-for-height and body mass index.
99% (intention-to-treat analysis).
Children in the intervention group had a greater decrease in weight-for-height and body mass index than the routine care group at both 6 months (end of treatment) and 12 months (table). At 6 months, more children in the intervention group achieved ⩾5% reduction in weight-for-height, but the benefit was not statistically significant at 12 months (table).
A group intervention for parents and children was more effective than routine care for weight loss in obese children.
Kalavainen MP, Korppi MO, Nuutinen OM. Clinical efficacy of group-based treatment for childhood obesity compared with routinely given individual counseling. Int J Obes (Lond) 2007;31:1500–8.
Clinical impact ratings: Family/General practice 7/7; Obesity 6/7; Paediatrics 6/7; Patient education 6/7
Childhood obesity is increasing at an alarming rate and is associated with a host of avoidable medical conditions and their complications that follow the child into adulthood. We know that an overweight child is likely to remain so in adulthood and that the few available treatment options have not been shown to provide clinically significant benefits.1 It is also clear that risk of childhood obesity is determined by various complex influences including, but not limited to, biological and psychological factors, ethnic disparities, food insecurity, and poverty.2
Treatment options for childhood obesity need to address these complexities. Kalavainen et al appropriately recognised the need to include both children and parents in the treatment of obesity. The initial results are encouraging. However, the intensity of the intervention (15 90-min sessions) is probably impractical in routine clinical settings and, as the authors postulated, is a potential barrier to parental involvement. The issues of cost-effectiveness, recruitment of participants, and availability of expertise in delivery of the intervention must be considered before implementation of such a programme.
Future research could be targeted at determining the most effective timeline for delivery of the programme, with investigation as to which aspects of the programme produce the greatest effects and highest levels of participation. Finally, the inclusion of long-term follow-up could be implemented to encourage continued benefits.
Source of funding: Scientific Foundation of Finnish Association of Academic Agronomists, Finnish Cultural Foundation of Northern Savo, Juho Vainio Foundation, Ministry of Social Affairs, and Health and Social Insurance Institution.
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