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Brian H. Wrotniak, MS; Leonard H. Epstein, PhD; Rocco A. Paluch, MS; James N. Roemmich, PhD

Arch Pediatr Adolesc Med. 2004;158:342-347.

Background  Family-based behavioral weight control treatment involves the parent in the modification of child and parent eating and activity change.

Objective  To assess if parent standardized body mass index (z-BMI) change predicts child z-BMI change.

Design  Secondary data analysis based on parent and child z-BMI changes from 3 family-based, randomized, controlled weight control studies. Hierarchical regression models tested whether parent z-BMI change increased prediction of child z-BMI change through treatment and 24-month follow-up beyond other factors that influence child weight change, such as child age, sex, socioeconomic status, and baseline child and parent z-BMI. Differences in child z-BMI change as a function of quartiles of parental z-BMI change were tested using an analysis of covariance.

Setting  Pediatric obesity research clinic.

Participants  Obese 8- to 12-year-old children and their parents from 142 families who participated in family-based weight control programs.

Main Outcome Measures  Child and parent z-BMI changes over time.

Results  Parent z-BMI change significantly predicted child z-BMI change for the 0- to 6-month (P<.001) and 0- to 24-month (P <.009) time points. In hierarchical regression models, parent z-BMI change was a significant incremental predictor of child z-BMI change at 6 and 24 months, with the additional r² ranging from 11.6% at 6 months (P <.001) to 3.8% at 24 months (P = .02). Parents in the highest quartile of z-BMI change had children with significantly greater z-BMI change than that of children with parents in the other quartiles (P = .01).

Conclusion  Parent z-BMI change is an independent predictor of obese child z-BMI change in family-based behavioral treatment, and youth benefit the most from parents who lose the most weight in family-based behavioral treatments.

From the Departments of Pediatrics (Messrs Wrotniak and Paluch and Drs Epstein and Roemmich) and Social and Preventive Medicine (Dr Epstein), School of Medicine and Biomedical Sciences, The State University of New York at Buffalo.

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