Family-based weight management program improved self-perception among obese children

Battling the childhood obesity epidemic is a priority for many researchers, as obesity during adolescence increases the risk of chronic diseases throughout life. Because obese children have lower quality of life and self-esteem, greater levels of depression and anxiety, and also face more teasing and bullying than normal-weight peers, including mental health in any intervention is necessary. To that end, researchers studied the self-perception of children participating in the Fit Families program.

Fit Families is a program based on Social Cognitive Theory delivered through the New Mexico Cooperative Extension service. The program was developed for areas of southern New Mexico lacking resources to help combat childhood obesity in a positive, culturally appropriate manner by encouraging healthy food and nutrient intake and increased physical activity. For this study, children with a body mass index at least in the 85th percentile were referred by local physicians. The final study included 46 children, ranging from 8 to 17 years of age, 43% of whom were male, and 80% of whom were Hispanic.

"With our emphasis on fun physical activity, children and parents reported enjoying the games at Fit Families. We believe this may have resulted in the children's increased self-perception related to their athletic ability," said Martha Archuleta, PhD, RD, lead author of the study. "Children also improved the perception of their physical appearance, possibly due to the way self-acceptance and diversity of body sizes were promoted."

The program was delivered to children and their family members in a series of seven weekly sessions lasting 2 hours 45 minutes. Sessions began with a meal as an incentive for attendance, to make attendance more manageable for busy families and served as examples of nutritious, quick meal plans that families could replicate at home. After the meal, a registered dietitian taught nutrition education, a professional coached a physical activity component, and a school counselor led a lesson on feeling positive. Goal-setting was stressed during the sessions and each topic included a hands-on activity and discussion.

Among the participants, significant improvements were noted for self-perception of athletic competence and physical appearance after the conclusion of the weekly sessions. Changes in self-perception of scholastic competence, social acceptance, behavioral conduct, and global self-worth were not significant, however.

This study used a small convenience sample and was not randomized, limiting the ability to generalize it to other groups and settings. However, including a mental health component in weight-management programs seems warranted because it is important to address the whole child, which is not currently emphasized in treatment recommendations.

"Use of community-based childhood obesity interventions such as Fit Families provides a holistic approach to weight management that promotes positive self-perception, which may decrease the burden of depression, anxiety, and low self-esteem obese youth face. It could be a cost-effective way to improve the physical and mental health of children and set them on a more optimal pathway to becoming healthy adults," emphasized Dr. Archuleta.