Baseline characteristics & 6-month outcomes of Healthy LIFE: a family-based, self-pay, multidisciplinary group treatment program for long term pediatric weight management.
DEBRA GILL, Ph.D., HENRY ANHALT, D.O., SEAN NEALY, B.A.,
Department of Pediatric Endocrinology, Saint Barnabas Medical Center, Livingston, NJ
Presented at annual meeting of NAASO, The Obesity Society, and published in Obesity (2006) Vol 14, p. A104.
Background:
The Healthy LIFE Pediatric Weight Management Program was launched at Saint Barnabas Medical Center July 2005 to meet the need for intensive family-based lifestyle intervention for overweight children. The program is unique in its focus on long-term skills and attitudes from the outset, treatment of parent-child dyad throughout, and substantial investment of time and money required from participants.
Objectives:
We intend to share information about the 45 families and children who chose to commit a significant amount of money (several thousand dollars) and time (2.25 hours per week for 24 weeks) to learning the behavioral, nutrition, and physical activity skills required for lasting weight management and lifestyle change. We also report physical, behavioral and psychological outcomes for program completers during our first year of operation.
Baseline Characteristics:
Demographics: Average age is 11.5 years (range 5 -17. Sex distribution was 20male & 25fem. Parents were highly educated (84% moms & 79%dads had some college; 39% of moms and 47% of dads had some graduate school). Most (65%) had income above $100K. Ethnicity was predominantly Caucasian or a mix with one Caucasian parent (72.7%). Other families were Black (13.6%), Hispanic (4.5%) or other non-Caucasian (6.8%). Most (85%) were two-parent families with 35% sharing responsibility of meeting attendance between mother and father. 14% fathers were primary attendee.
Baseline Body Composition and Weight: All but one participant had BMI >95%ile for their age and sex (62% were above 99th%ile). Body composition by DXA Scan (Dual X-Ray Absorbtometry) revealed avg total body fat of 39.3% (±4.7, range 29.8-48.1%). Avg waist circumference 40.46in (±7.53, range 28-60); avg hip circumference 42.12in (±7.29; range 30-60). Avg waist-to-hip ratio .97 (±.071, range=.81-1.18).
Baseline Behavior: Binge eating was very rarely reported in this group (QEWP-parent and adolescent report). Parent ratings of baseline frequency of participants’ healthy behaviors suggested most participants were already “sometimes” eating healthy and either “sometimes” or “regularly” physically active (mod 30min, 5d/wk or vig 30min 2d/wk). Interestingly, while healthy eating frequency of participants was not rated similarly to that of other family members, physical activity frequency of participants was rated similarly to that of siblings, parents and extended family unit.
Outcomes:
Retention and Satisfaction: 34/45 participants completed 24 session program. Retention rate was 76% with most dropouts due to family crises. Satisfaction with the program was very high among completers with average ratings from 4.25-4.7 across four various 1-5 rating scales.
Body Composition and Body Shape: Average DXA total body fat% loss was 3.5% (±3.96) which represents a 9% reduction in body fat from baseline (paired t=4.036; p<.001). Tanita BIA revealed 10% reduction in baseline fat weight (4.5 lbs body fat lost). Concurrently, 1.5lbs of lean mass was gained. Waist Circ and Hip Circ were significantly reduced (p>.0001) as were reported clothing and belt sizes. Anecdotal and/measured evidence of improved fitness was found for all participants.
Self-Confidence and Fitness: Subjective ratings (1-5 scale) of self-confidence, body self confidence and fitness improved (p<.0001) over 24 weeks.
Planned future reports will include detailed analysis of: changes in self-concept, behavioral skills used by the most successful participants, predictors of success, and quantitative descriptions of eating, activity, fitness, body composition and weight patterns of participants at months 0, 6, 12, 24, 36 and beyond.
Author Contact Information: Debra Gill, Ph.D. dgill@sbhcs.com (973)322-7620
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