Pediatric obesity remains a serious health problem in the United States, where one in five children are affected. The U.S. Preventive Services Task Force now recommends that pediatricians screen for obesity during primary care visits and refer families to behavioral intervention programs. While there is growing interest in providing these services, accessibility continues to challenge their success.

To address this, researchers at University of California San Diego School of Medicine conducted a randomized clinical trial comparing the leading treatment program, Family-Based Treatment (FBT), with a new Guided Self-Help (GSH) program designed to provide similar resources in a less intensive and more accessible way.

The study, publishing June 17, 2022 in Pediatrics, found that GSH and FBT were similarly effective in supporting pediatric weight loss, but families were more likely to maintain attendance in GSH.

In the clinical trial, 164 children and their parents were randomly assigned to one of the two programs. Participants were recruited from two clinic sites in San Diego County, which primarily serve Latino families. The prevalence of childhood obesity in these neighborhoods (Escondido and Chula Vista) is 38 percent.

The traditional FBT program consists of 20 one-hour group sessions over six months. FBT is held at academic research centers, which adds geographical constraints. Attrition rates in these programs are high, with many parents noting scheduling issues, transportation difficulties and competing work and family responsibilities as contributing factors.

In response to these challenges, the GSH model was developed to provide shorter treatment sessions and greater scheduling flexibility. The new program consists of 14 visits, each 20 minutes in length and held at the child’s primary care clinic. Families are given material to practice between sessions in a self-directed manner, and then meet individually with a health coach to review and troubleshoot strategies.

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