Early treatment of childhood obesity reaps long-term benefits, study flags

18 Sep 2023 --- Researchers suggest early treatment of obesity in children is effective in the short and long term. The six-year study followed 170 children in Sweden who received treatment for diagnosed obesity. The parental support groups did not involve the children and instead focused on how parents could positively promote healthy lifestyles in the family without conflict.

At the start of the study, all kids were between four and six years old. Participating children and their parents were randomly assigned to one of three groups, either receiving a standard treatment – meetings focusing on diet and exercise with a doctor, pediatrician or dietician – or a ten-week parental support program, with or without follow-up telephone support. 

Half of the participants also received a follow-up phone call. 

“The children in all three groups improved their weight status and saw a reduction in their degree of obesity,” says lead researcher Paulina Nowicka, associate professor in pediatric science at the department of clinical science, intervention and technology, Karolinska Institutet and professor of food studies, nutrition and dietetics at Uppsala University. 

“The children whose parents received parental support had the best results, especially those who also received follow-up calls. We also found that more children in this third group showed a clinically relevant improvement of their weight status associated with better metabolic health, which means better blood lipids and glucose levels.”

Overcoming child obesity  
Nowicka explains that parental support groups focused on discussions about setting boundaries, how to teach children new behaviors and how to communicate with preschools, grandmothers, neighbors and other adults in the children’s world. 

She notes that most parents know what food to serve their children but highlights: “What do you do with a child who loves food and always wants to eat, or one that’s always hungry? How do you go about it without making a taboo of food?” 

“You have to try to build a clear structure at home that makes the child know that lunch is on its way and that they’ll be getting supper.”

In addition, parents need to do things together to strengthen family bonds, Nowicka suggests. For example, “getting the child involved in the cooking, giving them vegetables if they’re hungry and not rewarding them with food. It’s also important to ensure food isn’t associated with emotions and achievement.”

Getting kids involved in cooking helps to strengthen family bonds and reduce child obesity, suggests Nowicka.Safe and effective treatment for preschoolers 
The study, published in the International Journal of Obesity, indicates that treating obesity early has a lasting effect. Moreover, Nowicka explains that the study shows intensive treatment is safe and efficacious for preschool children. 

“Treating children at that age is much more effective than if you start treating them in their teens,” she says. “Some adolescents are looking at possible bariatric surgery, and we hope this can be avoided with earlier treatment.” 

Though studies have been done on children treated for obesity, most have only followed up after six months or a year, adds Nowicka. “We have no data on how the children fared over a longer period than that.”

Kids in all three intervention groups lowered their body mass index (BMI) between 38-67 months. Participants in the standard treatment group lowered their BMI by an average of 0.25 kg/m2, children in the parental support group without telephone follow-up lowered their BMI by 0.34 kg/m2 and kids whose parents received follow-up phone calls reduced their BMI by 0.45 kg/m2 on average. 

The researchers note that further research should investigate how to assess weight changes in growing children. 

Growing child obesity 
The World Obesity Federation cautions that obesity rates rise fastest among children and adolescents. The organization has predicted that by 2023, girls’ obesity will increase by 125% compared to 2020, while it expects boys’ obesity to double. 

Earlier this month, researchers flagged that skipping breakfast could trigger childhood obesity while eating a large breakfast was found to be beneficial for appetite control. 

To tackle child obesity, the American Academy of Pediatrics published a report at the start of the year that proposes weight loss drugs or surgery in addition to nutritional diets. At the same time, scientists have warned that prescription weight loss drugs do not offer a long-term solution as many people gain back the weight lost after stopping the treatment. 

Edited by Jolanda van Hal