Low-intensity family therapy intervention is useful in a clinical setting to treat obese and extremely obese children.
OBJECTIVE
To study the influence of low-intensity solution-focused family therapy with obese and extremely obese pediatric subjects on body mass index (BMI) z-scores and self-esteem.


METHODS
Fifty-four obese children, aged 6-17 years, were referred to an outpatient obesity clinic. The families received solution-focused family therapy provided by a multidisciplinary team. Height and weight were recorded; BMI and BMI z-scores were derived. Self-esteem was assessed with a validated questionnaire, "I Think I Am." Parents completed "The Family Climate Scale" assessing family dynamics.


RESULTS
Eighty-one percent of the children (n =44, mean age 11.9 years, mean BMI z-score 3.67, range 2.46-5.48) and their parents participated in the follow-up. Eleven children were treated for 6-12 months, and 33 for more than 12 months. On average, the families received 3.8 family therapy sessions. Intervention resulted in a mean decrease in BMI z-score of 0.12 (p =0.0001). Self-esteem on the global scale improved after intervention (p =0.002), and also on sub-scales, depicting physical characteristics (p <0.001), psychological well-being (p =0.026), and relations with others (p =0.046). The Family Climate Scale showed improvement in the sub-scales for Expressiveness (p = 0.002) and Chaos (p =0.002).


CONCLUSIONS
Solution-focused family therapy provided by a multidisciplinary team to obese and extremely obese children may prove useful in the clinical setting, with a positive impact on obesity and self-esteem.
Nowicka
Paulina
P
Childhood Obesity Unit, University Hospital Malmö, Malmö, Sweden. paulina.nowicka@skane.se
Pietrobelli
Angelo
A
Flodmark
Carl-Erik
CE
D000293:Adolescent; D015992:Body Mass Index; D002648:Child; D005195:Family Relations; D005196:Family Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009765:Obesity / Q000503:physiopathology / Q000523:psychology / Q000628:therapy*; D009767:Obesity, Morbid / Q000503:physiopathology / Q000523:psychology / Q000628:therapy*; D010348:Patient Care Team; D000297:Psychology, Adolescent; D002666:Psychology, Child; D012649:Self Concept; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome