Analysis Provides New Information for Treating Childhood Obesity
Contact: Prof. Doug Nangle at (207) 581-2045; Joe Carr at (207) 581-3571
Increasing the “dose” of behavioral interventions — the use verbal and tangible rewards, self-monitoring and stimulus control — and parental involvement can enhance the effectiveness of established diet and exercise regimes for combating childhood obesity, according to psychology researchers at the University of Maine, who conducted a meta-analysis of 13 years of treatment studies.
The meta-analysis of 11 published studies conducted since 1994 provides new information about the effectiveness of existing treatments for childhood obesity by identifying patterns among the therapeutic components.
“Whereas meta-analyses typically examine the effectiveness of interventions versus control (i.e., no treatment) conditions, this study employed a variation of the statistical techniques to estimate whether or not modifying or adding to obesity treatments helps youth lose more weight. This statistical approach has not previously been used in social science or medical research. This is the first of its kind, in the obesity or other treatment literatures,” says Professor of Psychology Douglas Nangle, director of clinical training at UMaine and visiting professor of psychology at Bowdoin College.
A major goal of the meta-analysis was to determine whether there were ways to improve the short- and long-term effectiveness of established behavioral therapies for pediatric obesity.
“Most of the time you see published reviews or read treatment studies and infer what seems to work,” says Nangle, one of the six authors of the study. “Meta-analysis provides a more objective, thorough, statistical way to make comparisons to find an effect. In a lot of fields, we know some treatments are better, but through analysis like this, we can evaluate the different treatment components and see if there are ways to enhance overall efficacy or demonstrate that one active treatment has advantages over another.”
The meta-analysis started four years ago as a class project in a graduate course on child and adolescent treatments. The idea to apply this variation in meta-analytic statistical techniques to allow for the comparison of active treatment components came from one of the graduate researchers on the project, Michael Cassano, who worked on its refinement with Jeffrey Hecker, another study coauthor, UMaine professor of psychology and interim dean of the College of Liberal Arts and Sciences.
“People have been researching pediatric obesity for decades and the good news is treatment works. Yet it’s not as effective as we’d like it to be,” says Nangle. “Usually, we’re not capable of getting kids into the normal range of BMI (body mass index) and the effects of treatment (most often comprehensive diets, decreased sedentary lifestyle and increased exercise) don’t have as long-lasting effects as we would like.
“We’re trying to find ways to get an extra push out of that core comprehensive intervention.”
The analysis showed that the already established comprehensive interventions combining diet/decreased sedentary lifestyle/increased exercise components could be made even more effective through enhanced behavioral interventions — rewards such as praise and incentives — for meeting physical activity and dietary goals, as well as teaching children to better self-monitor their eating and exercise patterns, and stimulus control, such as making healthy foods more easily accessible and identifiable.
“Part of behavioral intervention has to do with teaching kids to do better monitoring of what they actually eat and getting parents involved,” says Nangle. “The more efforts to make sure kids comply with diet and exercise, the better.”
The study also found another way to boost the effectiveness of existing treatments is through the involvement of parents. That involvement ranges from providing nutritious foods in the home and parental weight loss to modeling healthy eating h