Optimal Parental Role in Teen Obesity Treatment Not Yet Clear

By Lisa Rapaport

August 25, 2020

(Reuters Health) - Family-based interventions are recommended for teen obesity treatment, but a research review of randomized controlled trials finds no clear evidence of the optimal role for parents in treatment plans targeting weight loss in adolescents.

Researchers identified just 32 studies, including 23 randomized controlled trials, that assessed weight-related outcomes of adolescent obesity interventions that included parents. Only five trials tested specific parent roles in adolescent obesity interventions.

Most interventions lasted four to six months, and all of the interventions included lifestyle modifications like adjusting diet or exercise behaviors to aid weight loss. Four trials tested the effectiveness of interventions provided to parents and teens together, versus separate sessions for parents and adolescent children.

"There is some evidence that parental involvement might result in greater adolescent weight loss, compared with interventions that included parents or adolescents alone - but larger studies are needed to strengthen these findings," said study coauthor Melanie Bean, co-director of the Healthy Lifestyles Center at Children's Hospital of Richmond at Virginia Commonwealth University.

"Developmentally, adolescents still need their parents for both instrumental - meals, transportation - and relational - emotional support and attachment - needs," Bean said by email. "Yet results of this review did not clarify the optimal way to engage parents to help their adolescents lose weight."

Results of the few trials in the analysis were also mixed.

For example, one study that randomly assigned parents and teens to attend joint or separate lifestyle management sessions looked at white mother-adolescent dyads and found teens lost more weight when they had separate but concurrent group sessions.

However, another study with a similar design that involved Black dyads found no differences in teen weight loss based on whether they were randomized to joint or separate sessions with mothers. This study did find teens lost more weight when their mothers had better attendance records with the sessions than when mothers missed more sessions.

Two other studies randomly assigned both teens and parents, or only teens or only parents, to receive lifestyle management. These studies found adolescents lost more weight when both they and their parents attended lifestyle management sessions than when the intervention targeted only teens or only parents.

Researchers didn't have enough data to conduct a meta-analysis.

Even so, the results reaffirmed that parents and families can have a crucial role in the treatment of adolescent obesity, said Dr. Sandra Hassink, author of a commentary accompanying the study and medical director of the American Academy of Pediatrics Institute for Healthy Childhood Weight.

"While the specific nature of successful parental involvement needs more study, the need for parents to understand how to support their adolescents in managing the home nutritional and activity environment, positively supporting their lifestyle goals, and facilitating their access to and participating in their obesity treatment remains," Dr. Hassink said by email.

SOURCE: https://bit.ly/32ol0Xo and https://bit.ly/3gkgn5K Pediatrics, online August 24, 2020.