Healthy Living News

Parents' Role in Weight Control Assessed

by Claire McCarthy, M.D.
Harvard Medical School

A new report calls for more research to find the best ways for parents and other caregivers to fight obesity in children. The American Heart Association issued the statement. It reviewed studies that took different approaches. Some of these have been linked to better results. They include changing behaviors as a family, setting clear goals, keeping track of progress and keeping healthy foods in the home. About 17% of the studies found that kids lost more weight when parents were involved in treatment. Some studies also found that a role for parents also helped kids to keep weight off longer. But in other studies family involvement did not make a difference. The study authors said research has not focused enough on the roles of culture, family relationships and parenting styles, among other things. The journal Circulation published the study. HealthDay News wrote about it January 23.

What Is the Doctor's Reaction?

As a pediatrician and a parent, it seems plain old obvious to me that anything we do to fight the childhood obesity epidemic needs to involve parents and other adult caregivers. After all, they are the ones who:

• Shop
• Pack lunches
• Cook meals
• Take kids to McDonald's
• Sign them up for soccer
• Buy video games and televisions
• Make decisions about how much time kids spend in front of them

Basically, there is nothing I can do as a pediatrician that doesn't involve a parent or caregiver.

So I was pretty excited about a new scientific statement from the American Heart Association (AHA). It's called "Evaluating Parents and Adult Caregivers as Agents of Change for Treating Obese Children."

The first part of the statement goes through the core behavior change strategies for obese youth. The AHA says these strategies are "grounded in strong theoretical models." They include:

• Choosing specific habits or behaviors that should change
• Writing down or keeping track of a target behavior such as what children eat or how much they exercise
• Setting goals
• Limiting temptations
• Offering support for good behavior (such as rewarding kids for making good food choices)
• Using self-efficacy and self-management skills (learning willpower!)

The authors talk about ways that parents and adult caregivers can implement these strategies. Again, it seemed somewhat obvious to me that involving all caregivers is necessary for any of these strategies to work.

But in the second section, when they reviewed studies on the effect of parent and other caregiver involvement, do you know what they found?

It wasn't at all clear that caregivers made a difference in treating child obesity.

To be fair, some studies did show that it made a difference. Also, most of the studies only kept track of kids and families for a few months. This may not have been long enough to show real results. But nevertheless, it was discouraging.

So what is going on? Maybe parents and caregivers really don't make a difference -- but that's hard to believe. Maybe that's not the explanation. Maybe parents need more education and support to be effective. Or -- and this is the most likely explanation -- maybe our overall efforts to treat childhood obesity just aren't effective.

The last section of the statement discussed possible areas of research. For example, what is the role of family relationships when it comes to childhood obesity? What is the role of genetics, or culture? What are the best changes to make in the home environment? What are the best parenting practices if we want to keep kids at a healthy weight?

The parent, the child and the environment each play an important role in childhood obesity, the authors say. We need to understand each one separately before we can understand how they work together.

That's the central problem here. There's no obvious solution for the treatment of childhood obesity. If there were, we'd have had it fixed by now. It may be obvious that parents and caregivers need to be involved. But the best way to involve them is far from obvious -- and they aren't the only solution.

What Changes Can I Make Now?

If you are a parent or caregiver of a child, you should:

• Know your child's body mass index, or BMI, and know if it's healthy. Your doctor is your best resource. The U.S. Centers for Disease Control and Prevention (CDC) website has a great BMI calculator for kids. It also includes lots of useful information about healthy eating and exercise.
• Know your own BMI. Overweight parents are more likely to have overweight kids. The reasons involve genes and also family lifestyle habits. Which leads me to…
• Take a long, hard, honest look at your family's lifestyle. Do you exercise? How much is the TV on? Is there soda in the fridge? Are your habits as healthy as they could be?

What Can I Expect Looking to the Future?

As I have said many times in news reviews related to childhood obesity, unless we make some real changes what we can expect is more overweight kids. And those kids are far more likely to grow into overweight adults. This will bring a future load of medical, emotional, social and financial problems.

This scientific statement helps us understand how parents and caregivers might be able to help fight child obesity. And it also points out what we need to study if we are going to make them really helpful. That's just the kind of information we need if we are going to save our children's future.

Categories: Heart Health, Children's Health, Family Health, Nutrition Guide

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