Parents as the exclusive agents of change in the treatment of childhood obesity

Background: Excessive weight in childhood is a serious public health concern because of its costly health consequences and its increasing prevalence. Objective: Our objective was to compare the efficacy of a family- based approach for the treatment of childhood obesity, in which the parents served as the exclusive agents of change, with that of the conventional approach, in which the children served as the agents of change. Design: This study had a randomized, longitudinal prospective design and lasted 1 y. Sixty obese children aged 6-11 y were randomly allocated to the experimental (parents as agents of change) or control (children as agents of change) group. Anthropometric and biochemical measurements were determined at the start and end of the study. A sociodemographic questionnaire and a family eating and activity habits questionnaire were completed by both parents. Hour-long support and educational sessions were conducted by a clinical dietitian: 14 sessions for the parents in the experimental group and 30 sessions for the children in the control group. Results: The dropout rate was nine times greater in the control group (n = 9) than in the experimental group (n = 1). Mean percentile weight reduction was significantly (P < 0.03) higher in children in the experimental group (14.6%) than in the control group (8.1%). Conclusions: Treatment of childhood obesity with parents as the exclusive agents of change was superior to the conventional approach, as indicated by the dropout rate and the percentage weight loss of the children during the 1-y intervention.