Family-based Behavioral Weight Loss Programs: A Risk to Siblings?

Would such programs put siblings at risk years later?

Family-based behavioral weight loss programs are effective for reducing childhood obesity in the long and short term. Part of the program involves changing the home environment. Parents are encouraged to modify both their regular food and physical activity environments to support healthier choices for the whole family. This means limiting access to high-fat, high-calorie foods and increased use of fruits and vegetables. Changing the activity portion involves limiting the number of computer and television screens at home, and time spent watching television, playing video games, and using computers for long periods (Pediatr Obes. 2019. 14:e12477).

Increased risk to siblings?

A group led by Dr. Batya Shaharabany at Maccabi Health Care Services, Haifa, Israel, sought to explore if one unexpected result of such family-based weight-loss programs might be increased risk for developing eating disorders among siblings (Obes Res Clin Pract. 2020. 14:279).

To test their theory, the authors designed a 30-month  retrospective follow-up study of two groups (18 families in an intervention group and 26 families in a control group), and a 14-month prospective follow-up study including families with one or more obese or overweight children 8 to 14 years of age (42 families and 78 children and siblings). All the parents and children participated in a multidisciplinary parent-child program called Maccabi Active. The researchers used the results from the children’s version of the eating attitude test (ChEAT) questionnaire, family eating and activity habits questionnaire (FEAHQ) and BMI z-scores.

No increase in disordered eating behaviors was found among children with overweight or obesity or their siblings, doing away with concerns about the development of disordered eating after participation in a family-based intervention.  In fact, improvements in the obesogenic environment pointed to potential benefits for the entire family, according to the authors.

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