Study: behavioral management key to weight loss in children

Obese children can use behavioral management to lose weight, according to a study conducted at the Kaiser Permanente Center for Health Research in Portland.

School-age kids and teens can lose weight or prevent additional weight gain by participating in medium- to high-intensity behavioral management programs. The finding is part of a report released Monday by the federal Department of Health and Human Services through its Agency for Healthcare Research and Quality.

Children in most of the programs met once or twice a week for six months to 12 months. The study looked at programs at schools, specialty health care settings and primary care facilities.

“Almost all the studies looked at multiple approaches, which makes good sense because obesity is an imbalance between input and output,” said Dr. Evelyn Whitlock, author of the report.

Behavioral tactics include “setting goals, rewarding behaviors, planning ahead, setting up an environment for success, and planning what to do if you have a slip,” said Whitlock, an investigator at the Portland research center.

Obese children who completed the programs weighed less than their peers — from three pounds to 23 pounds, the study found. The weight differences were greatest among heavier children as well as in those enrolled in more intensive programs. Researchers also found that weight improvements could be maintained for up to a year after the programs ended.

About 17 percent of U.S. children and teens are obese, according to the body mass index. A 16-year-old girl who is 5-foot-4 and 168 pounds, for example, is obese. Obese children and adolescents are at higher risk for asthma, type 2 diabetes, fatty liver disease, sleep apnea and other weight-related medical problems. They may also suffer psychological harm if teased because of their appearance.

Adding prescription drugs to a behavioral weight management program helped extremely obese adolescents lose weight. Side effects included mild increases in heart rate or blood pressure, abdominal pain and fecal incontinence.