Top Things to Know: Parent and Adult Caregivers as Agents of Change for Treating Obese Children
- In a national survey related to skills and competencies in managing childhood obesity:
- 39% of pediatricians perceived themselves as having low proficiency and skills in behavior strategies;
- 31% of registered dietitians (RDs) and 25% of pediatricians perceived themselves has having poor parenting management techniques;
- 46% of RDs and 30% of pediatricians rated themselves poor in assessing family conduct.
- The US Preventive Service Task Force recommends screening children at age 6 for obesity and offering intensive counseling or behavioral interventions for obese kids.
- The frequency of self-monitoring is a reliable indicator of weight loss in children and adults, and increasingly easier with technology that is focused on diet and exercise.
- Identifying specific, reachable goals such as daily intake of particular foods, amount of physical activity, and modifications in the home is more effective than non-specific or unrealistic changes for modifying behavior in children and adults.
- Multiple exposures to healthier foods, approximately 14 times for preschool age children, as well as choice, positively influence children to eat healthier.
- Curtailing consumption of unhealthy foods among children is stimulus control, which includes positive reinforcement, restricting locations in the home for eating, not allowing television in children’s rooms, using smaller dinnerware, relocating snacks to be less visible, and limiting weekly visits to fast food restaurants.
- Among 12 studies, only 2 studies found significant short-term differences in overweight children dependent on the degree of parental involvement, but the 3 studies with the longest follow-up assessments and the other 3 studies that included a no-treatment group did achieve better child outcomes.
- The greatest 2-year reductions in overweight children were predicted by greater preplanning of meals by children and role modeling of healthy behaviors by parents.
- Many parents, specifically mothers with a high school education or less, do not perceive their children as obese and therefore do not encourage appropriate eating behaviors.
- Given the limited and inconsistent evidence regarding parents influence on their children’s weight, more research is needed to identify specific parenting strategies that will allow parents and adults to be more effective.
Citation
Faith MS, Van Horn L, Appel LJ, Burke LE, Carson JAS, Franch HA, Jakicic JM, Kral TVE, Odoms-Young A, Wansink B, Wylie-Rosett J; on behalf of the American Heart Association Nutrition and Obesity Committees of the Council on Nutrition, Physical Activity and Metabolism, Council on Clinical Cardiology, Council on Lifelong Congenital Heart Disease and Heart Health in the Young, Council on Cardiovascular and Stroke Nursing, Council on Epidemiology and Prevention, and Council on the Kidney in Cardiovascular Disease. Evaluating parents and adult caregivers as “agents of change” for treating obese children—evidence for parent behavior change strategies and research gaps: a scientific statement from the American Heart Association. Circulation. 2012: published online before print January 23, 2012, 10.1161/CIR.0b013e31824607ee.