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Child Obesity Treatment Programs
How to Reduce Obesity in Children and Teenagers
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Child Obesity Treatment Programs

Child Obesity Studies
A number of studies have reported that the prevalence of child obesity is continuing to increase at an alarming rate. Recent studies from Leeds show that by the age of eleven, as many as 30 percent are overweight and 17 percent are obese (<85th and >95th BMI centiles respectively) (Rudolf et al. 2002). Many studies have also shown that BMI tracks from childhood to adulthood, which has major implications for adult morbidity in the coming decades. Other studies have shown that obese teenagers already have the cardiovascular, glycemic and lipid changes associated with increased adult disease risk (Freedman, 1999). Perhaps of even more importance to the children is the social and emotional morbidity that is associated with being overweight or obese.

Child Obesity & Intervention
Given the increasing prevalence of childhood overweight and obesity and associated morbidities, it is important to establish appropriate and successful interventions to tackle the problem of obesity in the pediatric population. It is worth noting that at this time there is no program of health care currently available for this group. There is also a lack of research evidence on successful intervention programs. However, the need for appropriate interventions for overweight and obese children is well acknowledged and there are a number of groups in the UK that are engaged in intervention work with overweight and obese children. Examples of the work of some of these groups will be discussed in the presentation, highlighting where appropriate the similarities and differences in the approaches used by the different groups.

Child Obesity Support
Some common elements are the use of a multidisciplinary approach to intervention, combining expertise from psychology to support the behaviour change element, exercise science to support the physical activity element and nutrition to support the dietary element. Some of the interventions are based on the important work of Epstein from the USA. One important requirement used by some of the UK groups is the child centred focus of the intervention, placing emphasis on understanding the specific needs and lifestyle of the individual children. The framework of principles and practices that underpin the intervention are then contextualised to the individual requirements of the participant, in terms of factors such as likes and dislikes, choices and opportunities that are related to successfully changing their current eating and activity behaviour.

Child Obesity & Intervention Programs
There is not only a need for the development of successful intervention programs, but also for the sharing of good practice based on evidence of effective intervention programs. Such evidence is not currently available from randomised controlled trials conducted in the UK, but it will not necessarily accumulate from such an approach, given the limitations of this form of design for evaluating interventions for obesity where weight loss is the treatment (Lean, 2000). Evidence of what works for different children in different contexts in facilitating behaviour change associated with an evaluation of change in eating and activity behaviour, fitness and body composition are all ideally required to evaluate intervention programs for overweight and obese children.

Source: Professor C B Cooke, School of Leisure & Sport, Leeds Metropolitan University, Leeds, LS6 3QS, UK

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