High-dose specialized family-based behavioral weight loss treatment (FBT) facilitates healthier eating habits and greater reductions in weight among overweight and obese children and their parent(s), according to a randomized study published in JAMA Pediatrics.

Investigators of this randomized study (ClinicalTrials.gov identifier: NCT00759746) evaluated the impact of a FBT consisting of high or low doses of either enhanced social facilitation maintenance (SFM+) vs weight-control education (control) on weight reductions or weight loss mediators.


A total of 172 parent-child dyads who completed FBT were subsequently randomly assigned to receive 8 months of SFM+ (high: n=59 vs low: n=56) or control (n=57) treatment. Investigators recruited children who were overweight or obese and had at least 1 parent who had BMI ≥25.

Participants in the low SFM+ group experienced better outcomes than those in the control group (difference, -3.34; 95% CI, -6.21 to -0.47; d =-0.40; P =.02). Compared with those in the low SFM+ group, those in the high SFM+ group demonstrated better overall outcomes (difference, -3.37; 95% CI, -6.15 to -0.59; d =-0.38; P =.02). Additionally, the high SFM+ group demonstrated better outcomes than the control group (difference, -6.71; 95% CI, -9.57 to -3.84; d =-0.77; P <.001).


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The high SFM+ group lost significantly more weight than the low SFM+ group (difference, 18.00; 95% CI, 1.00-34.00; P =.03) and the control group (difference, 34.00; 95% CI, 16.00-51.00; P <.001). The investigators found that healthy behaviors with peers, monitoring and goal setting, and family and home environment all had a mediating effect on those in the high SFM+ group vs the control group (25%-42%).

Because this study was performed in an academic research setting, the results may not be generalizable for primary care or community settings.

There is a childhood obesity epidemic, and the investigators suggest, “there is an urgent need to translate effective family-based weight-management interventions, like SFM+, into routine clinical care.”


Wilfley DE, Saelens BE, Stein RI, et al. Dose, content, and mediators of family-based treatment for childhood obesity: a multisite randomized clinical trial [published online October 30, 2017]. JAMA Pediatr. doi: 10.1001/jamapediatrics.2017.2960