Jane Garbutt, M.B., Ch.B.
Project Overview:
One in five children in the U.S. is now overweight and the prevalence of obesity is increasing in adults and children. The cause of this recent epidemic is thought to be unhealthy eating and sedentary lifestyle. After age 3, overweight children are more likely to become overweight adults.
Treatment of obesity is extremely difficult. Intensive treatment interventions for obese school-aged children that involve parents have led to marked and sustained weight loss for the child and the parent. However, such specialized treatment is not widely available and is expensive. The Internet is a way to efficiently deliver intensive behavioral modification and social support programs for obesity treatment, and Internet access is available in the majority of homes with children in the United States.
This project has two parts. First, we will develop Food for Thought, an integrated, Internet-delivered intervention that targets parents of overweight 3 to 6 year olds as the agent of change for the family. To develop Food for Thought, we will modify Student Bodies 2, a 16-week Internet-delivered intervention for adolescents with weight and body image problems. Food for Thought will include basic education on nutrition and physical activity for children and adults, parenting behaviors around eating, and healthy weight control. In addition, participants will learn how to use behavior change techniques to identify areas for improvement, set goals and make changes to reach those goals. Parents will access the program for about 2 hours a week, at times that are convenient for them. In addition, parents will record their own and their child’s weight, food intake, and amount of physical activity each week using a private, on-line journal and will receive individualized feedback from a moderator. The website will also serve as the forum for moderated discussion groups among participants. The discussion group will be available at all times for parents to post messages asynchronously. Participants will also receive a pedometer to self-monitor walking.
In the second part of the project, 20 parents of overweight 3 to 6 year olds (sex- and age-specific Body Mass Index greater than the 85th percentile) will participate in Food for Thought. Participants will be recruited through a practice-based research network of 66 pediatricians in the St. Louis area. Before and after the intervention, the child’s pediatrician will measure the child and parent’s height and weight and we will calculate their body mass index (BMI). In addition, the parent will complete telephone interviews using validated instruments to measure the level of physical and sedentary activity, and dietary intake of fruit, vegetables and fat before and after the intervention for the parent and child.
We hypothesize that children and parents who participate in Food for Thought will experience weight loss (reduction in BMI z-score) and will demonstrate a reduction in high-fat food consumption and sedentary activity, and an increase in the amount of physical activity, fruit and vegetable consumption compared with their baseline status. Food for Thought is a novel approach to a significant problem. The program has broad applicability to other a large population and could be adapted to target for other diseases or life-style risk factors.
Final Report:
One in five children in the US is now overweight and the prevalence of obesity is increasing in adults and children. The cause of this recent epidemic is thought to be unhealthy eating and sedentary lifestyle. Treatment of childhood obesity is extremely difficult, but may reduce obesity-related morbidity and treatment costs in adulthood. Intensive treatment interventions for obese school-aged children that involve parents have led to marked and sustained weight loss. However, such specialized treatment is not widely available and is expensive. The Internet is a way to efficiently deliver obesity treatment, and Internet access is available in the majority of homes with children in the United States.
