title: Controlled study of critical parent and family factors in the obesigenic environment.
abstract: 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.
authors.affiliation: 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
authors.forename: Meg H
authors.initials: MH
authors.lastname: Zeller
authors.forename: Jennifer
authors.initials: J
authors.lastname: Reiter-Purtill
authors.forename: Avani C
authors.initials: AC
authors.lastname: Modi
authors.forename: Joeanne
authors.initials: J
authors.lastname: Gutzwiller
authors.forename: Kathryn
authors.initials: K
authors.lastname: Vannatta
authors.forename: W Hobart
authors.initials: WH
authors.lastname: Davies
mesh_terms: 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