Changing Parental Style for the Management of Childhood Obesity: A Multi-Component Group Experience


  • Paola Iaccarino Idelson Department of Public Health, University of Naples Federico II
  • Eugenio Zito Department of Translational Medicine, University of Naples Federico II
  • Enza Mozzillo Department of Movement and Wellbeing Sciences, Parthenope University of Naples
  • Mary Lista Department of Translational Medicine, University of Naples Federico II
  • Sara Mobilia Department of Translational Medicine, University of Naples Federico II
  • Giuliana Valerio Department of Movement and Wellbeing Sciences, Parthenope University of Naples
  • Adriana Franzese Department of Translational Medicine, University of Naples Federico II



Obesity, weight management, multi-component-group-programme, parenting style, behavior


Obesity is a complex public health issue with increasing prevalence in childhood and with a large burden on physical and mental health. Recent data suggest the effectiveness of multi-component approach, of interventions aimed at changing parenting style, and of group educational sessions. In particular, interventions containing a family-behavioral component produce larger effect sizes than alternative treatment groups. Many models have been developed for the multi-component and multi-stakeholder treatment of childhood obesity, with a frequent discrepancy in the intensity of the treatment programme and in the resources available within clinics. Looking for effective strategies for the treatment of childhood obesity we built a Multi-component Obesity Group Experience (MOGE) model, analysing BMI and fat mass reduction as primary outcomes and qualitative improvements in the behavior towards nutrition and lifestyle as secondary one. Thirty-five consecutive obese children (20 girls, BMI z-score 2.1+0.2), were treated by MOGE model and the results were compared with 35 matched obese subjects of the same age (control group followed with a traditional treatment). After 3, 6 and 12 months of treatment it has been observed a significant reduction of BMI z-score and body fat mass. Moreover, a clinically significant psychological wellness was observed in children of MOGE group.


[1] Ogden CL, Kuczmarski RJ, Flegal KM, et al. Centers for Disease Control and Prevention 2000 growth charts for the United States: improvements to the 1977 National Center for Health Statistics version. Pediatrics 2002; 109: 45-60.
[2] Valerio G, Licenziati MR, Manco M, et al. Health consequences of obesity in children and adolescents. Minerva Pediatrica 2014; 66: 381-414. Available from
[3] Wang Y, Lobstein T. Worldwide trends in childhood overweight and obesity. International Journal of Pediatric Obesity 2006; 1: 11-25.
[4] Levine MD, Ringham RM, Kalarchian MA, Wisniewski L, Marcus MD. Is family-based behavioral weight control appropriate for severe pediatric obesity? International Journal Eating Disorders 2001; 30: 318-28.
[5] Pomietto M, Docter AD, Van Borkulo N, Alfonsi L, Krieger J, Liu LL. Small steps to health: building sustainable partnerships in paediatric obesity care. Pediatrics 2009; 123: 308-16.
[6] Iaccarino Idelson P, Zito E, Mozzillo E, et al. Combined in- and outpatient multicomponent intervention on moderate/severe obese children. Int J Obes 2011; 1(Suppl 1): 14-5.
[7] Centis E, Marzocchi R, Di Luzio R, et al. A controlled, class-based multicomponent intervention to promote healthy lifestyle and to reduce the burden of childhood obesity. Pediatr Obes 2012; 7: 436-45.
[8] Whitlock EP, O’Connor EA, Williams SB, Beil TL, Lutz KW. Effectiveness of weight management interventions in children: a targeted systematic review for the USPSTF. Pediatrics 2010; 125: e396.
[9] Østbye T, Zucker N, Krause KM, et al. Kids and adults now! Defeat Obesity (KAN-DO): rationale, design and baseline characteristics. Contemp Clin Trials 2011; 32: 461-9.
[10] Sandler IN, Schoenfelder EN, Wolchik SA, Mackinnon DP. Long-term impact of prevention programs to promote effective parenting: lasting effects but uncertain processes. Annu Rev Psychol 2011; 62: 299-329.
[11] Youn KM, Northern JJ, Lister KM, Drummond JA, O’Brien WH. A meta-analysis of family-behavioral weight-loss treatments for children. Clin Psychol Rev 2007; 27: 240-9.
[12] Sacher PM, Kolotourou M, Chadwick PM, et al. Randomized controlled trial of the MEND program: a family-based community intervention for childhood obesity. Obesity 2010; 18: 62-8.
[13] Valerio G, Licenziati MR, Tanas R, et al. Management of children and adolescents with severe obesity. Minerva Pediatrica 2012; 64: 413-31. Available from
[14] Faith MS, Van Horn L, Appel LJ, et al. Evaluating parents and adult caregivers as “agents of change” for treating obese children: evidence for parent behavior change strategies and research gaps: a scientific statement from the American Heart Association. Circulation 2012; 125: 1186-207.
[15] Gerards SM, Sleddens EF, Dagnelie PC, De Vries NK, Kremers SP. Interventions addressing general parenting to prevent or treat childhood obesity. Int J Pediatr Obes 2011; 6: e28-e45.
[16] Zito E, Iaccarino Idelson P, Mozzillo E, et al. Psychological factors in moderate/severe childhood obesity. International Journal of Obesity 2011; 1(Suppl 1): 27.
[17] Golan M. Parents are key players in the prevention and treatment of weight-related problems. Nutr Rev 2004; 62: 39-50.
[18] Golan M. Parents as agents of change in childhood obesity-from research to practice. Int J Pediatr Obes 2006; 1: 66-76.
[19] Spear BA, Barlow SE, Ervin C, et al. Recommendations for treatment of child and adolescent overweight and obesity. Pediatrics 2007; 107: 254-88.
[20] Pinard CA, Hart MH, Hodgkins Y, Serrano EL, Mc Ferren MM, Estabrooks PA. Smart choices for healthy families: a pilot study for the treatment of childhood obesity in low-income families. Health Educ Behav 2012; 39: 433-45.
[21] Tibon Czopp S. Invited commentary: applying psychodynamic developmental assessment to explore mental functioning in adolescents. J Youth Adolesc 2012; 41: 1259-66.
[22] Ross MM, Kolbash S, Cohen GM, Skelton JA. Multidisciplinary Treatment of Pediatric Obesity: Nutrition Evaluation and Management. Nutr Clin Pract 2010; 25: 327-34.
[23] Robertson W, Friede T, Blissett J, Rudolf MC, Wallis M, Stewart-Brown S. Pilot of “Families for Health”: community-based family intervention for obesity. Arch Dis Child 2008; 93: 921-6.
[24] Kalarchian MA, Levine MD, Arslanian SA, et al. Family-based treatment of severe pediatric obesity: A randomized controlled trial. Pediatrics 2009; 124: 1060-8.

[25] West F, Sanders MR, Cleghorn GJ, Davies PS. Randomised clinical trial of a family-based lifestyle intervention for childhood obesity involving parents as the exclusive agents of change. Behav Res Ther 2010; 48: 1170-9.
[26] Teder M, Mörelius E, Bolme P, Nordwall M, Ekberg J, Timpka T. Family-based behavioral intervention programme for obese children: a feasibility study. BMJ Open 2012; 2: e000268.






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