Childhood Obesity Studies - Treatment
of Obesity
Childhood Obesity Studies Aim
The main objective of these two Cochrane reviews was to assess the effectiveness
of interventions that focused on diet, physical activity and/or lifestyle
and social support, and were designed to treat or prevent obesity in childhood.
Childhood Obesity Studies Methods
Currently there are a significant number of randomised controlled trials
(n=18, 7 from the same research team in US) which have assessed the effectiveness
of programs to treat childhood obesity. Many were run from a specialist
obesity clinic within a hospital setting. Two studies screened children
in schools; children were given the intervention at school in one study,
and under the supervision of a Pediatrician at a hospital in the other
study. The trials included children aged 7 to 12 years and were primarily
conducted in the United States. The remaining studies were conducted in
Austria, Australia, Israel, Sweden and Germany.
Childhood Obesity Studies Results
Most of the studies included in the treatment review were too small to
have the power to detect effectiveness. Carrying out meta-analysis did
not overcome this problem since few studies included the same comparisons
and outcomes. The results do suggest that there may be some additional
benefit to behaviour therapy where parents, rather than the child, are
given the primary responsibility for behaviour change. In addition, relaxation
may be as effective as behaviour therapy. Although there were many trials
which focused on changing levels of physical activity and/or sedentary
behaviour, these trials were too small to draw any conclusions. However,
the limited data from these trials is promising in favour of a reduction
in sedentary behaviour. Three of the four long-term studies that combined
dietary education and physical activity interventions resulted in no difference
in overweight, whereas one study reported an improvement in favour of
the intervention group. In two studies of dietary education alone, a multimedia
action strategy appeared to be effective but other strategies did not.
Of the two long term studies that only focused on physical activity one
resulted in a slightly greater reduction in overweight in favour of the
intervention group. Two short term studies of physical activity also resulted
in a slightly greater reduction in overweight in favour of the intervention
group.
Childhood Obesity Studies Conclusion
The findings of the review suggest that currently there is limited quality
data on the effectiveness of programs to treat childhood obesity, and
as such no generalisable conclusions can be drawn with confidence. However,
it seems reasonable to suggest that there may be some benefit in treatments
which 1) include a reduction in sedentary behaviours, 2) give the primary
responsibility for behaviour change to parents rather than the child.
In addition, relaxation may be as effective as behaviour therapy.
Childhood Obesity Prevention
As far as obesity prevention is concerned, there is limited high quality
data on the effectiveness of obesity prevention programs and no generalisable
conclusions can be drawn. However, concentration on obesity treatment
strategies that encourage reduction in sedentary behaviours and increase
in physical activity may be fruitful. The need for well-designed studies
that examine a range of interventions remains a priority, although a number
of important studies are underway.
Source: Summerbell C D, Kelly S A M, Waters
E, Edmunds L, Ashton V, Campbell K, School of Health, University of Teeside,
Middlesbrough, UK. (2002)
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