Low-intensity interventions help improve BMI in children with obesity

Low-intensity obesity interventions modestly reduce BMI in children, with one in five kids in the telephonic coaching condition achieving meaningful improvement in BMI z score, reports a recent study.

Investigators conducted a cluster-randomized clinical trial, in which 20 paediatric primary care practices were randomly assigned to telephonic coaching (Fitline Coaching) or mailed workbook (Fitline Workbook). Parents and their children (aged 8 to 12 years) with BMI ≥85th percentile completed assessments at baseline and at 6 and 12 months.

In total, 501 children (mean age 10.5 years, 47.5 percent female) and their parents received either Fitline Coaching (n=243) or Fitline Workbook (n=258). Of these, 26.8 percent had overweight, 55.4 percent had obesity, and 17.8 percent had severe obesity.

Both interventions demonstrated improvements in BMI percentile. The 12-month decline in continuous BMI z score did not reach statistical significance in either group. However, 20.8 percent of participants on telephonic coaching and 12.4 percent of those on workbook achieved a significant decrease of at least 0.25 in BMI z score, with a significant between-group difference (p=0.0415).

"[M]ore research is needed before such a program could be recommended for paediatric primary care practice,” the investigators said.

“The American Academy of Pediatrics recommends that paediatric practices help families make lifestyle changes to improve BMI, but provider time and access to treatment are limited,” they noted.