Maintenance Treatment Helps Kids Keep Weight Off

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SFM focuses on providing a positive social environment for the child. "It's based on the premise that people need a supportive environment for weight control," Wilfley explained. Parents were taught how to guide their children into getting in more physical activity, especially when having play dates. Parents were also taught ways to get kids to eat healthier foods when their peers were present. Wilfley said a lot of parents assumed that kids would balk if they weren't given pizza or burgers on a play date, and that those same parents were pleasantly surprised that kids were generally fine when they were given healthier options, such as fruit. Additionally, SFM helped children improve their body esteem and gave them skills to cope with teasing.

BSM focused on the specific behavior skills that children need to maintain their weight loss. Children were asked to monitor their weight and to immediately return to weight-loss strategies if they found their weight increasing. "It was really about teaching problem-solving skills for weight-loss management," Wilfley explained.

The study found that after two years of follow-up, children in maintenance treatment maintained about a one-quarter point drop in their body mass index (BMI) scores, while those receiving no maintenance treatment maintained an average of less than one-tenth of a point drop in BMI.

The author of an accompanying editorial, Dr. David Ludwig, director of the Optimal Weight for Life program at Children's Hospital Boston, said that while the effect of the maintenance programs was small and diminished when active treatment was over, either maintenance treatment was superior to no treatment at all.

Wilfley said one group in particular -- those treated with SFM who reported few social problems -- did better than the rest of the youngsters.

The bottom line, said Ludwig, is that overweight and obesity needs to be treated as a chronic health problem that needs long-term treatment.

"Overweight is caused by many factors -- a lack of physical activity, the nature of our diets, emotional factors, family dynamics, what's happening in our schools, and larger socioeconomic factors -- so any intervention that focuses on just one factor, such as a new diet, seems unlikely to succeed, said Ludwig, who is also an author of Ending the Food Fight: Guide Your Child to a Healthy Weight in a Fast Food/Fake Food World. "We really need to be viewing obesity as a chronic condition for which long-term attention will be needed."

Wilfley said she'd like combine the best aspects of both types of maintenance treatment and continue the treatment for a longer period of time to see if the children could be more successful at maintaining their weight loss.

More information

For more advice on helping kids lose weight and keep it off, read this information from the National Institute of Diabetes and Digestive and Kidney Disease's Weight-control Information Network.