Parents and their children appear to value both physical and psychological health as targets for treatment as part of a family-based weight-management program. These data may help inform the design and implementation of future programs.

Family-based weight-management programs (WMPs) are increasingly being used to provide multidisciplinary treatment for children and families with obesity, according to Amanda E. Staiano, PhD. With WMPs, parents and children attend sessions with trained counselors or coaches together as a family. Family-based behavioral treatments (FBTs) are used to simultaneously target children and their parents by promoting weight loss through healthy eating and exercise. With FBTs, parents are taught about ways to promote their child’s self-regulatory skills.

“It’s well known that children with obesity are at higher risk for developing cardiovascular and metabolic disease, but they also commonly experience low quality of life, stigma, and poor self-esteem,” says Dr. Staiano. “Many effective WMPs are available to help families achieve a healthier weight, but these programs are often not well attended. Families often cite difficulty finding time in their schedules to attend these programs or report having financial and motivational barriers.”

Looking for Results Beyond Weight Loss

For a study published in the Ochsner Journal, Dr. Staiano and colleagues assessed the attitudes of parents and their children regarding family-based WMPs. “At Pennington Biomedical Research Center—in partnership with Washington University in St. Louis, the University of Rochester Medical Center, and the American Academy of Pediatrics—we conducted focus groups with 30 children and 30 parents, mostly African American and diverse in income,” Dr. Staiano says. “We wanted to determine what families are looking for in a WMP and what might be standing in the way of them joining or attending a WMP.”

Parents and their children highlighted the importance of both physical and psychological health as targets for treatment in the study. “Both children and parents reported that effective program leaders, learning how to eat healthy, and involving parents were most important for a WMP,” says Dr. Staiano (Table). “Beyond weight on a scale or other health improvements, parents and kids wanted a program that helps them cope with weight-related bullying or teasing, increases self-esteem, helps them stick to healthy eating and physical activity, and keeps them motivated. They want to see other positive results, such as feeling good about themselves and having more energy.”

Building Positive Relationships

Based on the study results, Dr. Staiano says physicians should be talking to children and their parents about elevated weight and identifying resources and programs to help families achieve a healthier weight. “In addition, both physicians and coaches involved in WMPs need to be warm, welcoming, and nonjudgmental,” she says. “Parents in our study reported that it is very important to them that physicians and health coaches build a positive relationship with the entire family so that everyone will want to keep coming back to the program.”

When considering components of a WMP, it is important for physicians to think about the desires of both children and their parents. “Children are looking for meal plans, fun physical activities, and tools like apps or wearable devices to help them stick with a weight-management program,” says Dr. Staiano. “Parents are looking for eating guides to buy healthy foods and training to learn about why certain foods are healthy or unhealthy. Parents also want to know about free or inexpensive activity options, how to become a mentor or role model for their child, and how they can help keep their WMP fun and exciting so their kids will want to attend.”

Enhancing Family-Based Weight Loss

The information gathered from the study is an important step to appropriately enhancing family-based weight-loss interventions. “It should be noted that our focus groups were the first phase in the TEAM UP project, funded by the Patient-Centered Outcomes Research Institute,” explains Dr. Staiano. “We used these findings to inform our TEAM UP weight-management study, which is being delivered to more than 30 pediatric clinics across 3 states. Our hope is that these efforts will ensure patient buy-in and input on WMPs to improve enrollment and attendance so that we can ultimately help families lose weight in a healthy and sustainable way.”