Critical Analyses: Efficacy of Maintenance Treatment Approaches for Childhood Overweight

Efficacy of Maintenance Treatment Approaches for Childhood Overweight.

The purpose of this study was to determine if extending lifestyle interventions following the basic family-based behavioral weight loss treatment will cause a decline in relapses after treatment. These treatments are well established and have been proven to be effective, but the long term goal of keeping the weight off and continuing a healthy lifestyle has been the challenge that the majority of the patients seem to face. The researchers hypothesized that the children randomized to an extended treatment condition would better maintain weight loss in the short term and long term treatment plan compared with children assigned to only the standard-length weight loss treatment. The second hypothesis was that a child in a social facilitation maintenance (SFM) intervention would naturally produce better weight maintenance than a child in the behavioral skills maintenance (BSM) intervention.

The study used only the children who have been clinically diagnosed as obese. The sample was randomized, including 150 children between 7 and 12 years old who were 20% to 100% overweight and had at least one parent whose body mass index was above 25. Children were excluded if either themselves or their parent were actively involved in psychological and/or weight loss treatment. The participants were randomly assigned using computer generated random numbers. Assessment of the participants were conducted on day one of treatment and continually on months 5 (randomization), 9 (post weight maintenance), 17 (1-year follow-up), and 29 (2-year follow-up). Following month 5, the completion of the basic family-based behavioral weight loss treatment, children stratified by sex and the then put in order by combination of percentage weight change and a randomization of levels of social problems. Once in order the children were randomly distributed over 3 parallel groups, (1) BSM, (2) SFM or (3) control. Social facilitation maintenance intervention concentrates on an individuals peer relationships and self image, which is identified as the primary issue in overweight children’s lack of physical activity. The Behavioral Skills Maintenance intervention builds on the initial treatment but teaches weight maintenance skills that were not taught during weight loss treatment.

The participants in both the BSM and SFM were subjected to attend sessions that included a 20-minute family treatment and a 40-minute separate child and parent group. There were a battery of scales and assessments used to calculate the results. A Detecto balance beam scale was used to calculate body max index and a stadiometer was used to measure the height. The children where evaluated on there self-efficacy in choosing healthy foods using The Child Dietary Self-efficacy Scale. This scale evaluated the child’s ability choose healthier substitutes in order to rid unhealthy habits. Weight and body issues were assessed by The Child Eating Disorder examination. The Coping with Teasing measured the adequacy of children’s responses to teasing. The Social Support for Eating Habits/Exercise Survey was used to measure peer support for diet and physical activity. An individuals level of social problems were assessed by the social problems subscale of the Achenbach Child Behavior Checklist-Parent version. The parents were asked to classify the race of their children so the representatives of the geographic area could be monitored. The Hollingshead Socioeconomic Status Index was calculated using each families demographic variables. Using these testing instruments to asses the participants really insured the validity and reliability of the study. It also makes the study easy to replicate since the assessments’ are pre-made.

During the study either the BSM efficacy, the SFM efficacy or both may have been compromised.. The researchers artificially eliminated some key procedures to minimize procedural overlaps in the study. These items included deliberately leaving out self regulatory skills in SFM like detailed food monitoring. There were limitations in this study. The impact of the weight loss on the individuals health was not measured. Also they did not include a