Reports from Israel, Australia and Austria highlight recent research in obesity.

Study 1: Parent-only intervention appears to be the most beneficial for weight loss and healthy lifestyle choices among obese children.

According to a study from Israel, “There is a consensus that interventions to prevent and treat childhood obesity should involve the family; however, the extent of the child’s involvement has received little attention. The goal of the present study was to evaluate the relative efficacy of treating childhood obesity via a family-based health-centered intervention, targeting parents alone v. parents and obese children together.”

M. Golan and colleagues at the Hebrew University of Jerusalem explained, “Thirtytwo families with obese children of 6-11 years of age were randomized into groups, in which participants were provided for 6 months a comprehensive educational and behavioral program for a healthy lifestyle.

These groups differed in their main agent of change: parents-only v. the parents and the obese child. In both groups, parents were encouraged to foster authoritative parenting styles (parents are both firm and supportive; assume a leadership role in the environmental change with appropriate granting of child’s autonomy).”

“Only the intervention aimed at parents-only resulted in a significant reduction in the percentage overweight at the end of the program (p=0.02) as well as at the 1-year follow-up meeting,” determined investigators. “The differences between groups at both times were significant (p<0.05).

“A greater reduction in food stimuli in the home (p<0.05) was noted in the parentsonly group. In both groups, the parents’ weight status did not change. Regression analysis shows that the level of attendance in sessions explained 28% of the variability in the children’s weight status change, the treatment group explained another 10%, and the improvement in the obesogenic load explained 11% of the variability.”

The researchers concluded, “These results suggest that omitting the obese child from active participation in the health-centered program may be beneficial for weight loss and for the promotion of a healthy lifestyle among obese children.”

Golan and colleagues published their study in British Journal of Nutrition (Childhood obesity treatment: targeting parents exclusively v. parents and children. Br J Nutr, 2006;95(5):1008-1015).

For more information, contact M. Golan, Hebrew University of Jerusalem, School Nutrition Science, IL-76100 Rehovot, Israel.

Study 2: Study finds high total energy intake, not low physical activity and low total energy expenditure, was the main determinant of high body weights in children.

According to a study from Australia, “Estimating changes in weight from changes in energy balance is important for predicting the effect of obesity prevention interventions. The objective was to develop and validate an equation for predicting the mean weight of a population of children in response to a change in total energy intake (TEI) or total energy expenditure (TEE).”

B.A. Swinburn and colleagues at Deakin University described, “In 963 children with a mean ((plusminus)SD) age of 8.1(plusminus)2.8 y (range: 4-18 y) and weight of 31.5 (plusminus)17.6 kg, TEE was measured by using doubly labeled water. Log weight (dependent variable) and log TEE (independent variable) were analyzed in a linear regression model with height, age, and sex as covariates. It was assumed that points of dynamic balance, called ‘settling points,’ occur for populations wherein energy is in balance (TEE=TEI), weight is stable (ignoring growth), and energy flux (EnFlux) equals TEE.”

The investigation revealed, “TEE (or EnFlux) explained 74% of the variance in weight. The unstandardized regression coefficient was 0.45 (95% CI: 0.38, 0.51; R(2)=0.86) after including covariates. Conversion into proportional chances (time[1] to time[2]) gave the equation (weight[2]/weight[1]) = (EnFlux[2]/EnFlux[1])(0-45). In 3 longitudinal studies (n= 212; mean follow-up of 3.4 y), the equation predicted the mean follow-up measured weight to within 0.5%.”

“The relation of EnFlux with weight was positive, which implied that a high TEI (rather than low physical activity and low TEE) was the main determinant of high body weight,” the researchers concluded. “Two populations of children with a 10% difference in mean EnFlux Would have a 4.5% difference in mean weight.”

Swinburn and colleagues published their study in American Journal of Clinical Nutrition (Estimating the effects of energy imbalance on changes in body weight in children.  Am J Clin Nutr, 2006;83(4):859-863).

For more information, contact B.A. Swinburn, Deakin University, School Exercise & Nutrition Science, 221 Burwood Highway, Burwood, Vic 3125, Australia.

Study 3: Conservative weight loss is a valuable option for the treatment of morbid obesity in some patients.

According to a study from Austria, “According to the literature, conservative weight loss seems to be ineffective for morbidly obese subjects. Nevertheless, the significance of nonsurgical strategies for the treatment of morbid obesity is still unclear. From 1999 to 2003,197 reconstructive operations were performed on 120 morbidly obese patients.”

“Initial body mass index (BMI) was higher than 35-40, and weight loss exceeded 40% of the original body weight. Gastric banding was performed in 66% of the patients; 34% reduced their body weight by conservative means. Conservative weight loss could be achieved at each level of BMI,” determined M. Mattesich and H. Piza-Katzer, Universitatskliniken fur Plastische.

The researchers concluded, “Conservative weight loss is a valuable option for the treatment of morbid obesity in a selected group of patients. Condiolates candidates for conservative weight loss should be selected carefully by a multidisciplinary team with psychiatric expertise.”

Mattesich and Piza-Katzer published their study in Chirurg (Plastic surgical considerations of conservative weight loss in the treatment of morbid obesity. Chirurg, 2006;77 (1):47-52).