A large US trial demonstrates that integrating family-focused behavioural therapy into routine paediatric care significantly improves weight outcomes for children with obesity, even amid pandemic challenges and diverse socio-economic backgrounds.
A large US trial suggests that family-based behavioural treatment can make a real difference for children with obesity when it is delivered in routine paediatric care rather than a specialist centre. Researchers said nearly half of children who received the programme alongside enhanced usual care achieved a clinically meaningful drop in weight, and the benefit held up over time.
The TEAM UP study, published in JAMA Pediatrics, followed 730 children aged six to 15 years across 41 primary care practices in Louisiana, New York, Missouri and Illinois. Families were assigned either to enhanced standard care alone or to that care plus family-based behavioural treatment, a structured programme that brought parents into the process and used repeated sessions to build habits around eating, activity and home routines.
At 12 months, children who received the extra behavioural support had greater improvement in body mass index measures than those in standard care alone, and the advantage remained at 18 months. The trial also found better weight-related quality of life in the more intensive programme, with no adverse events linked to participation. Families attended fewer sessions on average than the programme offered, yet still benefited, suggesting the model may be practical even when participation is imperfect.
The study is especially notable because it reflects the realities of everyday paediatrics. Roughly half of participating families had Medicaid coverage and about one in five reported food insecurity, while many children had conditions such as ADHD or anxiety that are often excluded from obesity research. More than three-quarters of the behavioural sessions were delivered by telehealth during the pandemic, yet outcomes were similar to in-person care. The findings also fit with the American Academy of Pediatrics’ guidance that intensive health behaviour and lifestyle treatment should be the foundation of care for children aged six and older, and they come at a time when drug treatment, including GLP-1 medicines, is drawing more attention as an option that may complement behavioural therapy rather than replace it.
Disclaimer: This content is for informational purposes only and is not intended to be a substitute for professional medical judgment, advice, diagnosis, or treatment.
