In a significant breakthrough, a randomized clinical trial published in “JAMA Network” has demonstrated the efficacy of family-based treatment for childhood overweight and obesity, challenging the traditional paradigm of speciality clinics. The study, reveals that implementing intensive behavioral interventions within pediatric primary care settings led to substantial and sustained improvements in weight outcomes for both children and their parents over 24 months.

In the quest to find the efficiency of intensive behavioral interventions, Leonard H. Epstein and his team assessed the influence of family-based therapy to tackle overweight or obesity in children and their parents and siblings. The trial enrolled 452 children in the age group of 6-12 years, with overweight or obesity, along with their parents and 106 siblings across four US settings.

Participants were randomly allocated to undergo family-based therapy or obtain usual care (226 in both the groups), with a comprehensive follow-up over 24 months. The family-based treatment employed different behavioral strategies to encourage eating healthy, physical activity or exercise, and improved parenting behaviours, with the aim of 26 sessions over the study duration. The number of sittings varied as per family progress.

At the 24-month mark, children who underwent family-based treatment exhibited more favorable weight outcomes compared to those who received standard care, as indicated by the difference in the change in percentage above the median BMI (−6.21% [95% CI, −10.14% to −2.29%]). Longitudinal growth models revealed that individuals—children, parents, and siblings—undergoing family-based treatment consistently demonstrated superior outcomes compared to those receiving usual care. These differences were evident at 6 months and sustained through 24 months. The changes in percentage above the median BMI from 0 to 24 months were 0.00% for family-based treatment vs 6.48% for children; −1.05% versus 2.92% for parents; and 0.03% versus 5.35% for siblings in family-based treatment and usual care, respectively.

Hence, family-based treatment for pediatric obesity and overweight demonstrated success in primary care settings, resulting in better weight outcomes for children and their parents over a 24-month period. Notably, even siblings who did not undergo direct treatment experienced improved weight outcomes, indicating the potential of this approach for families with multiple children.