A new UC San Diego clinical trial finds self-guided family-based treatment for obese children is easier, more affordable, and as effective as traditional, clinician-led approaches.

FBT is a clinically proven approach to treating children with obesity where a healthcare professional works with families to help their children lose weight by promoting physical activity, encouraging healthy eating habits, and teaching age-appropriate behavioral skills.

UC San Diego’s Center for Healthy Eating and Activity Research has found that self-guided FBT is also more flexible than more traditional models with scheduling and costs significantly less, as well as requiring fewer contact hours with a provider.

“Traditional FBT is an effective treatment method but can be time-intensive, can only be offered at specific times, and is expensive, which makes families facing difficult financial circumstances less likely to seek treatment,” said senior study author Kerri Boutelle, Ph.D., director of CHEAR and professor in the Departments of Pediatrics and Psychiatry at UC San Diego School of Medicine and the UC San Diego Herbert Wertheim School of Public Health and Human Longevity Science. “By providing the same core skills as traditional FBT in a more flexible and condensed format, we can increase access to treatment for families who may not be able to participate in traditional group-based programs.”

Boutelle pointed out childhood obesity is “incredibly complex” with numerous dietary, physical, genetic, and environmental factors contributing to the condition. “Each body is different regarding all the factors influencing how much they eat, whether they can resist bad habits, all of those things,” she said adding treatment therefore has to be individually customized.

But unlike adult obesity, which is often managed individually, helping children lose weight effectively has proven to be a family-based effort. Boutelle noted more traditional EBT treatments are done in small groups of parents with their 8- to 15-year-old children, allowing participants to “support each other.”

But there’s a catch to that method. “That treatment is 26 hours over six months, and requires a lot of time and space as well as skilled clinical interventions,” Boutelle said. “The self-help FBT treatment model we’ve developed has the same information, but takes only five hours of treatment in six months, without interventions, during 20-minute sessions every other week.”

Added Boutelle: “Previous studies suggest outcomes are improved with more contact hours. But we’re finding that the most important thing is working with parents, which can be done without a trained clinician. While some families may benefit from the standard approach, providing more flexible and accessible alternatives like self-guided FBT can help us make a wider impact on the epidemic of childhood obesity.”

Studies show about one in five U.S. children have obesity, which is associated with numerous negative health outcomes in children. Those include an increased risk of developing type 2 diabetes, high blood pressure, and asthma. Obesity in children is also associated with mental health concerns such as depression, anxiety, low self-esteem, and social isolation.

There is another benefit to self-help FBT for treating childhood obesity. “The treatment can be provided without someone being specially trained,” Boutelle said. “And it can be provided in a medical office where they (physicians) can see patients every other week. We hope that this information can be disseminated to the public through healthcare providers, health educators, and nurse practitioners. There is no reason to make people come in for treatment that much. It can be done just as effectively, more individually, and in a lot less time.”

To learn more about pediatric obesity treatment studies and other CHEAR research visit https://chear.ucsd.edu/.

CHILDHOOD OBESITY

There are multiple contributing factors to the condition including:

Diet:

• Consuming high-calorie, nutrient-poor foods (e.g., sugary drinks, processed foods, fast food).
• Eating large portions.
• Infrequent consumption of fruits, vegetables, and whole grains.

Physical Activity:

• Lack of regular physical activity.
• Spending excessive time watching TV, playing video games, or using electronic devices.

Genetics: Certain genes may increase a child’s susceptibility to weight gain.

Environment: Easy access to unhealthy foods, limited opportunities for physical activity, and social norms that promote sedentary lifestyles.