title: An intensive family intervention clinic for reducing childhood obesity.
abstract: BACKGROUND
  Childhood and adolescent obesity constitute a significant public health concern. Family health care settings with multidisciplinary teams provide an opportunity for weight loss treatment. The objective of this study was to examine the effect of intensive treatment designed to reduce weight using a parent-child lifestyle modification intervention in a family health care clinic for obese and overweight children who had failed previous treatment attempts.
  
  
  METHODS
  This was a practice-based 6-month intervention at Maccabi Health Care Services, an Israeli health maintenance organization, consisting of parental education, individual child consultation, and physical activity classes. We included in the intervention 100 obese or overweight children aged 5 to 14 years and their parents and 943 comparison children and their parents. Changes in body mass index z-scores, adjusted for socioeconomic status, were analyzed, with a follow-up at 14 months and a delayed follow-up at an average of 46.7 months.
  
  
  RESULTS
  The mean z-score after the intervention was lower in the intervention group compared to the comparison group (1.74 and 1.95, respectively; P = .019). The intervention group sustained the reduction in z-score after an average of 46.7 months (P < .001). Of the overweight or obese children, 13% became normal weight after the intervention, compared with 4% of the comparison children.
  
  
  CONCLUSIONS
  This multidisciplinary team treatment of children and their parents in family health care clinics positively affected measures of childhood obesity. Additional randomized trials are required to verify these findings.
authors.affiliation: Nutritional Services, Pediatric Gastroenterology and Nutrition Services, Maccabi Obesity Clinic, the Pediatric Department, Health Promotion and Preventive Medicine, the Medical Division, and Central Medical Management, Maccabi Healthcare Services, Tel Aviv, Israel; School of Public Health, University of Haifa, Haifa, Israel; the Department of Health System Management, Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva, Israel; and Sackler School of Medicine, University of Tel Aviv, Tel Aviv, Israel.
authors.forename: Ronit
authors.initials: R
authors.lastname: Endevelt
authors.forename: Orit
authors.initials: O
authors.lastname: Elkayam
authors.forename: Rinat
authors.initials: R
authors.lastname: Cohen
authors.forename: Ronit
authors.initials: R
authors.lastname: Peled
authors.forename: Limor
authors.initials: L
authors.lastname: Tal-Pony
authors.forename: Ruth
authors.initials: R
authors.lastname: Michaelis Grunwald
authors.forename: Liora
authors.initials: L
authors.lastname: Valinsky
authors.forename: Avi
authors.initials: A
authors.lastname: Porath
authors.forename: Anthony David
authors.initials: AD
authors.lastname: Heymann
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005194:Family Practice; D005195:Family Relations; D005260:Female; D006801:Humans; D008297:Male; D063766:Pediatric Obesity / Q000628:therapy*
keywords: Childhood Obesity; Early Medical Intervention; Health Education