Early treatment of child obesity yields lasting results

A new study led by researchers from the Karolinska Institutet has revealed that treating child obesity at an early stage can produce effective results in both the short and long term. The findings were recently published in the International Journal of Obesity.

Focus of the study 

The experts followed over 170 young Swedish children between the ages of four and six, who were diagnosed with obesity. 

The participants were enrolled through children’s clinics in Region Stockholm and were randomly assigned to one of three treatment modalities:

• Standard treatment focusing on diet and exercise with the guidance of healthcare professionals.
• A parental support group teaching parents how to encourage healthy lifestyles within their families without causing conflict.
• A parental support group paired with follow-up phone support.

The children and parents in the standard treatment group had meetings focusing on diet and exercise with a doctor. 

Parental support groups 

The two parental support groups did not involve the children and focused on how the parents could promote healthy lifestyles in the family in a positive way and without conflict.

“Such conversations can center on how to set boundaries, how to teach children new behaviors and how to communicate with preschools, grandmothers, neighbors and other adults in the children’s world,” said principal investigator Paulina Nowicka.

Long-term approach 

She emphasized the importance of their long-term approach. After attending the parental support groups, half of the participants were then randomly assigned a follow-up phone call. 

“Studies have been done on children who have been treated for obesity before,” said Professor Nowicka. “But most of them have only been followed up after six months or a year, so we have no data on how the children fared over a longer period than that.”

Lasting improvements 

Remarkably, children across all three groups displayed lasting improvements in their weight statuses and reductions in their obesity degrees. 

However, children whose parents participated in the support groups, especially those who also benefited from follow-up phone calls, exhibited the most significant results. 

“The children in all three groups improved their weight status and saw a reduction in their degree of obesity,” said Professor Nowicka. 

“The children whose parents received parental support had the best results, especially so those who also received follow-up phone calls. We also found that more children in this third group showed a clinically relevant improvement of their weight status associated with better metabolic health, by which I mean better levels of blood lipids and glucose.”

Relationships with food 

Professor Nowicka further emphasized that many parents already have an understanding of proper nutrition, but the real challenge is managing a child’s relationship with food. 

“They usually know this – but what do you do with a child who loves food and always wants to eat, or one that’s always hungry? How do you go about it without making a taboo of food?” 

“You have to try to build a clear structure at home, one that makes the child know that lunch is on its way and know that they’ll be getting supper.”

“But you also need to do things together to strengthen family bonds, like getting the child involved in the cooking, giving the child vegetables if they’re hungry and not rewarding them with food. It’s also important to make sure that food isn’t associated with emotions and achievement.”

Study implications 

The evidence strongly suggests that tackling obesity in pre-schoolers can produce fat better outcomes than waiting until the adolescent years.

“Treating children at that age is much more effective than if you start treating them in their teens. Some adolescents are looking at possible bariatric surgery and we hope that this can be avoided with earlier treatment.” 

This study was a collaboration between Karolinska Institutet, Uppsala University, Warwick Medical School, and Oxford University, and was funded by the Centrum for Innovative Medicine (CIMED) and the Masonic Home for Children in Stockholm Foundation.

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