Management of overweight pre-pubertal children - a randomised controlled trial

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Obesity is an increasingly common problem in the Australian community, affecting both adults and children. Up to 1 in 4 Australian children are overweight or obese, making it one of the most common chronic disorders in this age-group. Obesity in childhood is associated with such complications as high blood pressure, risk of diabetes, high cholesterol levels, hip, knee and ankle problems, and psychological distress. Given the impact of overweight and obesity on the health of children, how can it be best treated? Surprisingly, there is little information available to guide the management of this common problem. In this study we will test the hypothesis that the addition of a parent skills training program will significantly increase the effectiveness of a diet-activity program designed to reduce weight in overweight 6 to 9-year-olds. Children enrolled in the study will receive one of two interventions (i) parenting + activity-diet or (ii) diet-activity. Parents in the parenting intervention will participate in a parenting skills training program (Triple P) preceding the diet-activity program. Triple P comprises four 2-hour weekly group sessions and four, 15 minute follow-up phone calls which will focus on the skills and strategies required to supervise lifestyle changes. The diet-activity program comprises 8 group sessions for parents over a 5 month period on specific dietary and activity changes and simultaneous structured activity sessions for the children. Success will be judged in several ways. Over a 2 year period, we will monitor the child's weight, self-esteem, sense of well-being, blood pressure and cholesterol levels. We will also monitor the family's functioning and the parents' parenting skills and sense of efficacy. Results from the study should allow us to determine which treatment approach for management of childhood obesity is the most appropriate to be established in community settings.