Relationship between parent and child self-reported adherence and weight loss

Nutrition Research Newsletter, August, 2005

Family-based behavioral treatments for overweight youth are among the most successful for pediatric weight control, and meet evidence-based criteria for successful interventions. Weight change in these interventions depends on adherence to specific weight loss strategies, but there is limited research regarding the relationship between adherence to such behaviors and childhood weight control.

No known study has evaluated the separate and combined effects of both child and parent adherence on child and parent weight change, controlling for parent weight loss, nor have the incremental effects of adherence been examined after controlling for variables that influence weight loss. Therefore, a recent study evaluated which child and parenting behavioral strategies measured at 2 years were the best predictors of child and parent percentage overweight change, and then determined which child and parent self-reported adherence to behavioral strategies explains 24-month child and parent percentage overweight change, when accounting for variables that commonly influence weight loss.

One hundred and ten families with 8-year-old to 12-year-old children in >85th BMI percentile were included in this study. All families were provided with an educational program based on the Traffic Light diet and a physical activity program. The Traffic Light diet is a color-coded food exchange system that Categorizes foods based on macronutrient content. Height and weight were measured daily. Adherence to diet and physical activity was measured at 24 months, using a laboratory-constructed questionnaire.

Child adherence to weighing and to preplanning for celebrations where high-fat foods are served, and parent adherence to praising the child and modeling healthy eating habits predicted 24-month child percentage overweight change. Child adherence to recording food and calories and parent adherence to modeling healthy eating habits predicted 24-month parent percentage overweight change. Child weighing and preplanning and parent modeling were significant incremental predictors of 24-month child percentage overweight. Child recording and parent modeling were significant incremental predictors of 24-month parent percentage overweight change.

Child and parent adherence to specific components of family-based behavioral weight control treatment are independent predictors of long-term child and parent percentage overweight change. Additional research is needed to better understand how parent and child adherence influence child and parent weight change.

Brian H. Wrotniak, Leonard H. Epstein, Rocco A. Paluch, and James N. Roemmich. The Relationship Between Parent and Child Self-Reported Adherence and Weight Loss. Obesity Res; 13(6): 1089-1096 (June 2005). [Correspondence: Leonard H. Epstein, Department of Pediatrics, School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Farber Hall, Room G56, 3435 Main Street, Building 26, Buffalo, New York 14214-3000. E-mail: LHENET@acsu.buffalo.edu]