Kang Sim Dong-Jin E, Strong David R, Manzano Michael A, Rhee Kyung E, Boutelle Kerri N
Department of Pediatrics, UC San Diego, San Diego, California.
Department of Family Medicine and Public Health, UC San Diego, San Diego, California.
Pediatr Obes. 2020 Jun;15(6):e12622. doi: 10.1111/ijpo.12622. Epub 2020 Feb 12.
Family-based treatment (FBT) for children with overweight and obesity is a package that includes nutrition and physical activity education, as well as parenting and behavior therapy skills. To date, the majority of research suggests that one of the best predictors of child weight loss is parent weight loss. However, the bidirectional processes facilitating parent-child weight loss are not well understood.
To evaluate the strength and direction of parent-child weight-change patterns during a 6-month intervention with FBT for childhood obesity.
Parent-child weight change dynamics were evaluated using a bivariate multilevel approach.
Significant positive weight reductions throughout treatment were observed among both parents and children (P's < .01 for both parent and child). In the model adjusting for the conditional influence of attendance over time, parents' initial weight loss was associated with subsequent weight loss by their child (B = 0.102, P < .05; d = 0.352) across the first 10 sessions. Child's weight loss also was associated with subsequent weight loss by their parent (B = 0.105, P < .01; d = 0.412) across the first 10 sessions. A small and negative effects of parents' weight loss on children and children's weight loss on parents from sessions 10 to 20 may have been reflective of slowed rates of weight loss as treatment progressed.
Together these data suggest that parent-child dyads mutually influence weight loss in FBT. Future studies should leverage how to make best clinical use of these dynamic effects in the context of family-based interventions.
针对超重和肥胖儿童的家庭式治疗（FBT）是一个综合方案，包括营养和体育活动教育，以及育儿和行为治疗技能。迄今为止，大多数研究表明，儿童体重减轻的最佳预测因素之一是父母体重减轻。然而，促进亲子体重减轻的双向过程尚未得到充分理解。
评估在为期6个月的儿童肥胖家庭式治疗干预期间，亲子体重变化模式的强度和方向。
采用双变量多层次方法评估亲子体重变化动态。
在整个治疗过程中，父母和孩子的体重均显著下降（父母和孩子的P值均<0.01）。在调整随时间出勤的条件影响的模型中，在前10次治疗中，父母最初的体重减轻与孩子随后的体重减轻相关（B = 0.102，P <0.05；d = 0.352）。在前10次治疗中，孩子的体重减轻也与父母随后的体重减轻相关（B = 0.105，P <0.01；d = 0.412）。从第10次到第20次治疗，父母体重减轻对孩子以及孩子体重减轻对父母的影响较小且为负面，这可能反映了随着治疗进展体重减轻速度放缓。
这些数据共同表明，在家庭式治疗中，亲子二元组相互影响体重减轻。未来的研究应探讨如何在家庭干预的背景下最佳地临床利用这些动态效应。
