ORIGINAL RESEARCH Intervention in Overweight Children Improves Body Mass Index (BMI) and Physical Activity

Background: Childhood obesity is a growing epidemic in family medicine with few clinical treatment options. We implemented and evaluated a group office-visit intervention by family physicians for over-weight children and their parents, emphasizing nutrition and physical activity within a resiliency psy-chosocial model. Methods: The intervention lasted for 3 months, with half of the children crossing over to intervention after 6 months in the study. Participants included 35 children who met eligibility criteria of being in third through fifth grades and having a body mass index (BMI) above the 85th percentile. The 3-month, 12-session intervention, “Choices, ” included topics on nutrition, physical activity, and resiliency. The sessions were developed for delivery by a family physician and a nutritionist who received training in positive psychology and resilience skills. Main outcome measures were BMI z scores for age and sex and z scores for weight by age and sex, as well as qualitative interviews to understand individual and family processes. Results: The intervention resulted in a significant effect on one primary outcome, BMI z score (0.138 per 9 months [P .017]) and a trend toward significance on the weight for age z score (0.87 per 9 months [P .09]). The net shift of activity from the low metabolic equivalents (METs) to the high METs had an intervention effect of 2.84 METs (P .037). Families reported lasting changes in behaviors and attitudes. Discussion: The innovative approach used in this study demonstrated modest efficacy in reducing BMI z score, changing physical activity levels, and possibly shifting family dynamics. (J Am Board Fam Med 2013;26:126–137.