The prevalence of obesity continues to rise, and the striking increases in childhood obesity over the past several decades are particularly alarming. There is clearly an unmet need for more resources for treating overweight children. Published studies show that clinic-based childhood obesity treatments are more successful than adult treatments, as one third of children are no longer overweight ten years following treatment. There are a number of barriers to translating empirically based programs to a greater amount of the population, including a shortage of clinic programs with the expertise needed, cost and lack of resources. Clinic based programs are often time and cost intensive, as they require a parent and child to attend lengthy clinic visits weekly for up to 6 months. Guided self-help is a method that offers an opportunity to provide these empirically based programs to a larger amount of the target population. The guidance offered is not therapy in its purest sense, but includes clarifying material, answering questions, and helping the participant remain on task. Guided self-help treatments can be provided by health professionals who are not specifically trained in behavior therapy, can be less time intensive, and can potentially be provided through other modalities besides clinic visits. Guided self help has been utilized in a number of psychological treatment protocols, including phobia/panic disorders, depression, anxiety, eating disorders and obesity treatment in adult populations and naturally could be applied to the treatment of childhood obesity. The objective of this application is to test the efficacy of a guided self-help method for providing obesity treatment to parents and their overweight child. Specifically, this proposed study evaluates the use of a guided self-help method for treating 52 overweight children (aged 8-12 years old) and their parents for 6 months. Parents and children will be recruited from San Diego Metropolitan area and will be randomized to either an active treatment or a delayed treatment condition. The central hypothesis is that the guided self-help treatment will result in a larger weight loss in the overweight child as compared to a delayed treatment control.
The specific aims of this application are to 1) determine the extent to which the guided self-help program affects body weight in the target child, and 2) determine the extent to which the guided self-help program affects physical activity and dietary quality of parent and child, parent body weight, and home food environment. Participants will attend 12 20-minute clinic visits over 6 months, and assessment sessions at baseline, post-treatment and 6 months post-treatment. This efficacy study will be used as preliminary data to support the design of a full powered R01 randomized clinical trial. This program of research is critical for developing and disseminating interventions that can be translated to a larger amount of families with an overweight child.

Public Health Relevance

Almost a third of the children in the United States are overweight, and there is an unmet need to for more resources for treating overweight children. This research project could provide a treatment method for families with an overweight child that is efficacious, translatable and logically feasible, to ultimately provide treatment to more of the target population.

National Institute of Health (NIH)
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Exploratory/Developmental Grants (R21)
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Psychosocial Risk and Disease Prevention Study Section (PRDP)
Program Officer
Horlick, Mary
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University of California San Diego
Schools of Medicine
La Jolla
United States
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Accurso, Erin C; Norman, Gregory J; Crow, Scott J et al. (2014) The role of motivation in family-based guided self-help treatment for pediatric obesity. Child Obes 10:392-9
Boutelle, Kerri N; Norman, Gregory J; Rock, Cheryl L et al. (2013) Guided self-help for the treatment of pediatric obesity. Pediatrics 131:e1435-42
Cromley, Taya; Knatz, Stephanie; Rockwell, Roxanne et al. (2012) Relationships between body satisfaction and psychological functioning and weight-related cognitions and behaviors in overweight adolescents. J Adolesc Health 50:651-3