Obesity Fact #6 from the New England Journal of Medicine paper on obesity myths, presumptions and facts, also states the obvious:
“For overweight children, programs that involve the parents and the home setting promote greater weight loss or maintenance.”
In contrast, Programs provided only in schools or other out-of-home structured settings, although convenient or politically expedient, are less likely to yield positive outcomes.
As regular readers may recall, I have often stressed the points that perhaps on of the most effective things we could possibly do to prevent and better manage childhood obesity is to treat the parents.
The key word in this previous statement is “treat” – this goes well beyond simply “involving” the parents in a program designed primarily to help their kids. Readers may recall the study showing that the amount of weight that parents lost was a good predictor of the “success” of their kids.
I really mean “treating” the parents as I am convinced (although this has yet to be formally proven in an RCT) that parents, who successfully manage their own weight can be much more effective in creating a home environment that could help their kids.
I do not think that it is merely a coincidence that the kids born to mothers, who have undergone bariatric surgery, are far less likely to become obese (even as adults) than kids born to obese mothers, who have not undergone surgery.
I do not believe that this is specific to surgery, but could well be common to any form of successful weight management in the mother.
My number one advise to obese parents wanting to help their overweight kids would be to themselves first seek obesity treatment (and I don’t mean join the next commercial weight loss program).
Thus, apart from rare exceptions (such as monogenic forms of obesity or obesity associated with developmental or other specific issues that affect the kid alone), I would at least propose the “presumption” that “Childhood obesity programs must also treat the parents”.
Obviously, this may not be something that childhood obesity programs are primarily designed to do – which is why I have previously suggested geographically co-locating pediatric and adult obesity programs so that everyone in the family can be treated at the same time.
This, may not be easy to accomplish but perhaps some of my readers have experience with such an combined program or at least the efforts needed to create one.