Controlled study of critical parent and family factors in the obesigenic environment.
OBJECTIVE
Critical gaps remain in our understanding of the obesigenic family environment. This study examines parent and family characteristics among obese youth presenting for treatment in a clinic setting.


METHODS
Families of 78 obese youth (BMI z-score = 2.4; age, 8 to 16 years; 59% girls; 49% African-American) were compared with 71 non-overweight (BMI z-score = -0.02) demographically matched comparisons. Parents completed measures assessing family demographics, psychological distress (Symptom Checklist 90-Revised), and family functioning both broadly (Family Environment Scale: Conflicted, Support, Control) and at mealtimes (About Your Child's Eating-Revised: Mealtime Challenges, Positive Mealtime Interaction). Height and weight were obtained from all participants.


RESULTS
Compared with mothers and fathers of non-overweight youth, parents of obese youth had significantly higher BMIs (p < 0.001). Mothers of obese youth reported significantly greater psychological distress (p < 0.01), higher family conflict (p < 0.05), and more mealtime challenges (p < 0.01). Less positive family mealtime interactions were reported by both mothers (p < 0.01) and fathers (p < 0.05) of obese youth. These group differences did not vary by child sex or race. Logistic regression analyses indicated that maternal distress and mealtime challenges discriminated between obese and non-overweight youth after controlling for maternal BMI. Family conflict was explained, in part, by maternal distress.


CONCLUSIONS
Obese youth who present for treatment in a clinic setting are characterized by psychosocial factors at the parent and family level that differ from non-overweight youth. These data are critical because they identify factors that may be serving as barriers to a family's or youth's ability to implement healthy lifestyle behaviors but that are potentially modifiable.
Zeller
Meg H
MH
Division of Behavioral Medicine and Clinical Psychology, MLC-3015, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH 45229, USA. meg.zeller@cchmc.org
Reiter-Purtill
Jennifer
J
Modi
Avani C
AC
Gutzwiller
Joeanne
J
Vannatta
Kathryn
K
Davies
W Hobart
WH
D000293:Adolescent; D015992:Body Mass Index; D016022:Case-Control Studies; D002648:Child; D005191:Family Characteristics; D005192:Family Health; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008612:Menu Planning; D009034:Mother-Child Relations; D009035:Mothers / Q000523:psychology; D009765:Obesity / Q000453:epidemiology / Q000209:etiology / Q000523:psychology*; D010287:Parent-Child Relations; D010290:Parents / Q000523:psychology*; D018570:Risk Assessment; D013315:Stress, Psychological