Diet and Exercise Program for Families

OVERVIEW

A family-based obesity treatment program was designed to compare differences between a diet-only and a diet-plus-exercise program. Participants were randomly assigned to one of these treatment programs or to a no treatment control group.  While children in the control group gained weight by six months, children in both treatment groups experienced a reduction in percentage overweight at 6 months. At 12 months, the children in the two treatment groups were also similar, both groups having lost weight.

DESCRIPTION OF PROGRAM

Target population: Families with children ages 8-12

This study involved overweight children and parents who were taking part in a family-based obesity treatment program. Families who met study criteria were recruited to participate in the 15-session program, which included a final visit 12 months after the beginning of the program. Each of the families was randomly assigned to one of three groups. Two of the groups received the Traffic Light Diet, and one of these groups receiving a diet program also received an exercise program. A third group was a no-treatment control.

EVALUATION(S) OF PROGRAM

Epstein, L.H., Wing, R. R., Koeske, R., & Valoski, A. (1984).  Effects of Diet Plus Exercise on Weight Change in Parents and Children.  Journal of Consulting and Clinical Psychology, 52(3), 429-437.

Evaluated population: The study included fifty-three families who met the following criteria: had a child between 8 and 12 years of age; both child and participating parent were between 20-80% over their ideal weigh based on height, age, and sex;  parent and child had triceps with skinfold thickness over the 85^th percentile; the child had no learning disabilities and was not in psychiatric contact; parent agreed to attend all treatment meetings; and neither parent nor child had an existing medical problem that might contraindicate the exercise program. There were 18 families each in the two treatment groups and 17 in the control group.

Approach: Participants were randomly assigned to one of three conditions: diet, diet plus exercise, or a waiting-list control. Participants in the experimental conditions participated in the 15-session program, of which 8 sessions were held weekly, and then next 7 sessions spread out over the course of 20 weeks. Twelve months after the beginning of the program, a final visit was scheduled.  At six months, the control group received treatment.

Parents were required to make a deposit of $85 at the beginning of the program, and a portion of that was returned at several of the sessions throughout the length of the program. Point economies, given by parents to reinforce behaviors, were used after parents were trained in the management of these. Specifically, children were rewarded with points that could be used to obtain items they had ranked as desirable. Points were awarded for habit changes, keeping under four red (fattening) foods a week from the Traffic Light Diet used in the program, and weight loss of 0.5 to 1 lb per week.

The sessions involved review and discussion of the techniques and information previously presented, and the participants were seen in groups with the parent and child separated.

Participants in both experimental conditions followed the Traffic Light Diet, and those in the Diet-plus-exercise group also participated in a lifestyle change exercise program that required they gradually increase their caloric expenditure. Children in the diet only group received no such exercise program and were only provided with information on stretching and calisthenics.

Results: After 6 months, the control group was offered treatment and could no longer be used for comparison purposes. For children, at 6 months it was found that the both treatment groups were significantly lighter than the control group, and the control group had gained weight. Similar results were seen in the adults at 6 months and the diet-plus-exercise group lost more weight than the diet-only group of parents.  However, parents who lost the most weight in the first 6 months also regained the most weight during the next 6 months. In the case of the children, changes in the first 6 months were unrelated to changes in the second 6 months. Among children, there was a 15-20% reduction of percentage overweight at 6 months but no further reduction at 12 months.  Weight loss for parents and children was strongly related.

Results also indicate that for adults, the addition of exercise to diet improves the amount of relative weight change at both 6 months and 1 year. But in the case of children, exercise did not add to dieting at either of these time periods.

SOURCES FOR MORE INFORMATION

References

Epstein, L.H., Wing, R. R., Koeske, R., & Valoski, A. (1984).  Effects of Diet Plus Exercise on Weight Change in Parents and Children.  Journal of Consulting and Clinical Psychology, 52(3), 429-437.

http://www.trafficlightdiet.com/

Program categorized in this guide according to the following:

Evaluated participant ages: 8-12

Program age ranges in the guide: Middle Childhood

Program components: Parent/Family Component

Measured outcomes: Physical Health

Program information last updated 2/6/08.