Summary
The research table address the question “In obese children and adolescents with eating disorders, is behavioral intervention as effective as diet to reduce the incidence of obesity?” the questions is set to satisfy the PICOT design as follows
P=Patient problem or population: obese children and adolescents
I=Intervention: behavioral intervention/diet
C=Comparison: as effective as diet.
O=Outcome: reduction in the incidence of obesity.
T=Time: duration of implementation of all the interventions
The four studies were convenient for the children population mainly between the age of 0 to 8 -years, and essentially these studies may not be necessarily convenient for the adolescent population. Two of the studies (Duckworth ET al., 2009 and Campbell et al., 2013) included individual randomized control trials while the other two studies (Gortmaker et al., 1999 and Sahota et al., 2001) were designed a group or cluster randomized trials.
As demystified by the studies conducted by Campbell et al., (2013) and Gortmaker et al., (1999) it is apparent that obesity prevalence can be countered through multi-pronged approaches. Obesity among children is gradually evolving into a crisis and as such strategies should use schools and parents. Children spend the entire time in schools or at home. This means that a school-based approach and parent-based/focused approach should be sort in curbing obesity. As seen from the two studies, both parent-based and school-based approaches are associated with reduced intake of risk foods such as sweet snacks and high-fat foods. On the other hand, these two approaches enhance risk-alleviating behaviors such as consumption of fruits and vegetables, reduced television viewing and increased physical exercise.
On the other hand, Duckworth et al., (2009) and Sahota et al., (2001) are pretty in agreement with the other above-mentioned studies. All the studies appreciate the need to acknowledge that dietary changes without incorporating behavioral change is rather ineffective in curbing the rising obesity rates in children. Therefore, these studies underscore the need to use not only dietary approaches, but also behavioral strategies in combating obesity. For instance, behaviors such as increased hours of television viewing compromise physical activity or exercise-something that counters the beneficial effects of using a dietary approach.
The four studies associate obesity with behaviors such as television viewing and reduced levels of physical exercise. The modern-day lifestyles have so far proved to a major risk factor in propelling obesity prevalence. Parents are pre-occupied with other activities, and child-rearing roles have seemingly become a secondary role. The effect of reduced time between children and parents give children some degree of autonomy and freedom to choose what they want to eat. Amidst a consumerist market, food manufacturers have identified the niche and were using television advertisements to lure children to the irresistible confectionaries, noncore drinks and sweet snacks. This has significantly led to high consumption rates of unhealthy foods. Therefore, as exemplified by Campbell et al., (2013), parental interventions are of great importance in averting child obesity. When parental involvement is accompanied with dietary educative sessions, it becomes one of the most effective ways of controlling the consumption of unhealthy foods among children.
Limitations
While each of the studies achieved a significant level of findings that can be used to develop recommendations which would help avert the cases of obesity, overweight and related complications, there were apparent limitations to ache study which have been covered in another study or are yet to be explored extensively in future research. The limitations apparent to each of the studies included (1) comparatively small sample sizes and long durations for the study which potentially led to attrition (Campbell et al., 2012) (2) small groups sizes (Gortmaker et al., 1999) (3) There was minimal involvement of family in the program (Sahota et al., 2001) (4) Study sample size was determined by the number of participants who attended the camp as opposed to power calculations (Duckworth et al. (2009). While these studies may not have significant impacts on the final results, they tend to factor out a section of the population thus being less effective for generalization. However, a combination of the recommendations for each study would possibly help design effective methodologies that can be applied to reduce cases of obesity and overweight.
Conclusion
In conclusion, the fight against obesity cannot be won not unless a multi-faceted approach is taken. All the four studies converge at one point that parents and schools should be equally involved in fighting obesity. Moreover, more research should be done in this field to unearth other evidences and feasible approaches to fighting obesity among children.
References
Campbell, K. J., Lioret, S., McNaughton, S. A., Crawford, D. A., Salmon, J., Ball, K., & Hesketh, K. D. (2013). A parent-focused intervention to reduce infant obesity risk behaviors: a randomized trial. Pediatrics, 131(4), 652-660.
Duckworth, L. C., Gately, P. J., Radley, D., Cooke, C. B., King, R. F., & Hill, A. J. (2009). RCT of a High‐protein Diet on Hunger Motivation and Weight‐loss in Obese Children: An Extension and Replication. Obesity, 17(9), 1808-1810.
Gortmaker, S. L., Peterson, K., Wiecha, J., Sobol, A. M., Dixit, S., Fox, M. K., & Laird, N. (1999). Reducing obesity via a school-based interdisciplinary intervention among youth: Planet Health. Archives of pediatrics & adolescent medicine, 153(4), 409-418.
Sahota, P., Rudolf, M. C., Dixey, R., Hill, A. J., Barth, J. H., & Cade, J. (2001). Randomised controlled trial of primary school based intervention to reduce risk factors for obesity. Bmj, 323(7320), 1029.
