Program

Feb 06, 2008

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 85th
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.

KEYWORDS: Children (3-11), Middle Childhood (6-11),
Clinic-based, Home-based, Life Skills Training, Family Therapy, Physical
Health, Nutrition, Overweight, Obese

Program information last updated 2/6/08.