Obese children take control of their treatment

Researchers from the University of Glasgow have devised a new approach to treating childhood obesity.

And they have shown that the method is more effective at tackling the growing weight problem among children than current practices.

The team, led by Professor John Reilly, focused on lifestyle changes rather than weight loss and encouraged children to take control of their treatment and to take more physical activity.

The programme used a family-centred approach where the child and their relatives set the changes and nominated their own goals and monitored their own behaviour in order to achieve weight maintenance. Children learned to use a ‘traffic light system’ as part of treatment, with foods and drinks coded as RED (high energy foods and drinks- to be avoided except on special occasions), AMBER (restrict intake), GREEN (eat in any amounts).

Professor Reilly said: “Children were encouraged to alter their diet, to increase their physical activity and to restrict their sedentary behaviour, like TV viewing and playing computer games, to no more than two hours per day. Several behavioural techniques were used to motivate families and help them make lifestyle changes

“As the intervention focused on behaviour change rather than weight change, children were only weighed three times during the six month programme. 

“We compared the standard treatment programme used in the Scottish NHS with this new, practical, treatment programme. At the moment, obese children are offered 3 to 4 outpatient appointments delivered by paediatric dieticians over 6 to 10 months with a total patient contact time of 60-90 minutes

“Our method consisted of eight appointments - 7 outpatient visits and 1 home visit - over 26 weeks with a total patient contact time of around five-six hours.

“Both treatments had benefits for the children’s quality of life. The new treatment had greater benefits for weight and lifestyle, with increased physical activity and reduced sedentary behaviour, which we measured using activity monitors. But most importantly, it was well received by the children and their parents.”

Professor Reilly worked alongside researchers from the Sick Children’s Hospitals in Glasgow and Edinburgh and the results are reported in the March issue of the highly respected US medical journal  Pediatrics.

He added “Our study shows that treatment of childhood obesity can be both practical and beneficial. Children and their families can make and sustain modest changes in lifestyle if offered an appropriate treatment programme.

“There are no magic bullets available for treatment of childhood obesity but the results of this study provide hope that treatment programmes can work, and suggest that treatment should continue for periods of up to a year”.

Around 10 per cent of Scottish children are obese when they start school and around 20 per cent obese when they leave primary school. Children who are obese suffer a number of short and long-term problems, but treatment options for childhood obesity in many parts of the UK have been limited- treatment has been perceived as impractical, futile, or even harmful.

As a result, treatment for childhood obesity has not been offered in many parts of the UK, and no treatment programme which is practical for the NHS has been tested rigorously in a long term randomised controlled trial.

Funding for the research was provided by the Scottish Government Health Directorate Chief Scientist Office.

First published: 3 March 2008

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