In a recent study published in the International Journal of Obesity, scientists reviewed available literature to investigate the effectiveness of parent-only group-based interventions on the health status and behaviors of children.
Study: The effectiveness of group-based, parent-only weight management interventions for children and the factors associated with outcomes: A systematic review. Image Credit: Tero Vesalainen / Shutterstock.com
Childhood obesity typically continues into adulthood, thus indicating that once obesity is established, it is difficult to reverse. Obese children and adolescents are often subjected to emotional, social, and physical challenges; therefore, it is essential to address and prevent childhood obesity.
Family-based interventions are currently considered the most effective approach to controlling childhood obesity. However, interventions that involve the entire family can be expensive. Nevertheless, recent evidence suggests that parent-focused interventions that involve only parents and not the child are as effective as family-focused interventions in treating childhood obesity.
Although several systematic reviews have investigated the effectiveness of parent-only weight management interventions for children, these studies did not address preventative interventions for those at a higher risk of developing obesity. Furthermore, factors that affect weight management in children, such as self-esteem, sedentary time spent, and changes in diet and physical activity, were not considered.
The United States National Institute for Health and Care Excellence (NICE) assessed the effectiveness of weight management programs for children and adolescents. This study revealed that most of these programs are extremely short at around 12 weeks, thus limiting their ability to provide significant weight change. NICE also highlighted the importance of reflecting on health behavior changes after weight management programs.
About the study
In the current review, scientists critically assess available literature on the effectiveness of parent-only group-based interventions on children's health and health-related behavior. Herein, the researchers identified specific characteristics of participants and programs that influence these outcomes.
The current review obtained relevant articles from several databases, including the Cumulative Index to Nursing & Allied Health Literature (CINAHL), the Cochrane Database of Systematic Reviews, PsychINFO, MEDLINE, and Embase. Both published and unpublished articles were considered.
The initial search resulted in a total of 7,357 records. After removing duplicates and applying specific pre-determined inclusion criteria, fifteen studies were included in the review. All selected studies were randomized controlled trials (RCTs), published in peer-reviewed journals, and available in English.
All fifteen studies considered children with higher body mass index (BMI) or those with weight issues. This implies that children who did not have weight-related issues were not considered in the analysis despite these children potentially being vulnerable to low self-esteem and negative health behaviors that could impact future weight management.
Most trials observed that parent-only interventions can effectively improve a child's BMI and weight variables. Importantly, the positive changes sustained or even improved during the follow-up investigation two years after beginning the intervention.
Compared to child-only interventions, both parent-only and parent-child interventions exhibited similar effectiveness in improving obesity/overweight in children. Trials that compared the effectiveness of parent-only interventions with a parent-child intervention showed similar effectiveness.
Most of the studies in this analysis focused on children rather than adolescents. One prior study indicated that older children benefit more from family-based interventions than younger children, thus implying that older children are more adept at practicing skills taught in family-based intervention programs.
Parents have more influence on their eating and exercise habits in younger children. However, as a child ages, peers often replace parents' influence.
Overall, parent-only interventions exhibited higher dropouts as compared to the parent-child interventions. This finding indicates that the responsibility for a child's healthy weight could be overwhelming for some parents, which leads to dropouts in the parent-only groups. Thus, those who participate in parent-only interventions must be highly motivated and have strong family support.
Behavior changes in children are assessed based on physical activity and energy consumption based on modifications of the home-food environment. It was difficult to determine the behavioral outcomes of a child subjected to parent-only interventions due to poor trial quality.
Significantly low self-esteem was observed in obese/overweight children, thus demonstrating that self-esteem directly influences weight gain in children. Both parent-only and parent-child interventions led to improvements in the mental well-being of the children.
Parenting style also influences obesity. For example, controlling a child's feeding practice contributes to their weight gain, as it promotes eating problems.
Many parents control a child's behavior rather than regulating obesogenic factors in the home environment. Changes in obesogenic factors in the home environment improve children's weight and BMI.
- McDarby, F. & Looney, K. (2023) The effectiveness of group-based, parent-only weight management interventions for children and the factors associated with outcomes: A systematic review. International Journal of Obesity; 1-19. doi:10.1038/s41366-023-01390-6