Development and evaluation of a weight control program for obese preadolescent childre

Obesity is a common nutritional problem of American children. Health problems associated with childhood obesity and its continuation into adulthood underscore the need for effective weight control treatment for obese preadolescent children. The purpose of this study was to develop an effective weight control program that incorporated a structured low fat diet, regular exercise, behavior modification, family involvement and a fun learning environment. No weight control treatment for obese preadolescent children has incorporated these factors. The program was designed to teach obese preadolescent children methods to reduce their daily fat intake to between 25 and 30 percent of their total daily caloric intake.;Thirty-two obese preadolescent children were recruited from the Cheyenne, Wyoming, area with the assistance of local health care practitioners. Children were randomly assigned to the special intervention group or the standard care group. Children assigned to the special intervention group participated in a newly designed ten week weight control program for obese preadolescent children.;Children in the special intervention group changed the nutrient quality but not the fat quantity of their diets. These children, as indicated on their program evaluations and confirmed by nutrient analysis increased their consumption of fruits, vegetables, dairy products and meat. They did not use low fat food substitutions that were emphasized in the program. Analysis of activity factors confirmed that children in the special intervention group had increased their level of physical activity at weeks 10 and 22.;Children in the standard care group received the nutritional counseling usually provided by a registered dietitian at the local medical clinic. Children in the standard care group exhibited a significant improvement (P $le$ 0.05) in relative weight and BMI at weeks 10 and 22. Changes in dietary fat intake of children in the standard care group were associated with changes in their weight status indicators. The greater success of the standard care group was related to the level of family functioning and the type of individualized counseling provided as usual care. Results of this study suggest that obese preadolescent children from dysfunctional families could achieve a greater level of weight control success with individualized care than with a group based program.