title: Family-based obesity treatment, then and now: twenty-five years of pediatric obesity treatment.
abstract: OBJECTIVE
  Family-based treatments for pediatric obesity were developed over 25 years ago. Over that time, youth have become more obese and the environment more obesiogenic, which may influence efficacy of pediatric weight control. Mixed-effects regression models were used to compare the efficacy of programs initiated 20 to 25 years ago to current programs through 24-month follow-up, as well as to reanalyze 10-year outcomes of previous research using contemporary measures and analytic strategies.
  
  
  METHODS
  z-BMI and percent overweight.
  
  
  RESULTS
  Results showed significant reductions over time, with no differences in z-BMI change for older versus contemporary studies. Age was a predictor of z-BMI up to 24 months, with younger children showing larger change. Mixed-effects regression models replicated previous long-term effects of family-based interventions. Gender was a predictor of long-term z-BMI change, with girls benefiting more over time than did boys.
  
  
  CONCLUSIONS
  The efficacy of the family-based behavioral approach to treating pediatric obesity replicates over a 25-year period. Challenges in evaluating treatment effects over time are discussed. Ideas for studying choice of treatments that vary in effect size and for strengthening family-based behavioral treatments are noted.
authors.affiliation: Department of Pediatrics, School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY 14214-3000, USA. LHENET@acsu.buffalo.edu
authors.forename: Leonard H
authors.initials: LH
authors.lastname: Epstein
authors.forename: Rocco A
authors.initials: RA
authors.lastname: Paluch
authors.forename: James N
authors.initials: JN
authors.lastname: Roemmich
authors.forename: Meghan D
authors.initials: MD
authors.lastname: Beecher
mesh_terms: D000367:Age Factors; D001521:Behavior Therapy / Q000379:methods*; D015992:Body Mass Index; D005196:Family Therapy; D006801:Humans; D009765:Obesity / Q000628:therapy*; D050177:Overweight; D016896:Treatment Outcome; D015431:Weight Loss