Background

Family-based behavioral weight loss treatment (FBT) is an evidence-based intervention for pediatric overweight/obesity (OV/OB), but little research has examined the relative efficacy of FBT across income, socioeconomic status (SES), and racial groups.

Methods

241 youth (7-12 y; 61.6% female; 63.4% Caucasian, 22.1% African American (AA); child %OV=66.0±26.1; SES=43.0±10.3; 16.5% low-income) completed 4 months of FBT and 8 months of additional intervention (either weight-control or education control). Parents reported family income, SES (Barratt Simplified Measure of Social Status), and child race at baseline. Income was dichotomized with low-income defined as family income less than 50% of the area median family income. Treatment efficacy was assessed by child %OV (BMI % above median BMI for age and sex), which was objectively measured at baseline, at 4-months, and at 12-months. Separate fixed effects panel regressions examined group differences in child %OV across time for quartile SES, dichotomized income, and race (Caucasian vs. AA).

Results

All groups achieved and maintained clinically significant weight loss (at least -9 percentile point change from baseline) at 4-months and 12-months. However, low-income children had significantly less weight loss compared to higher-income children at 4-months but not at 12-months while AA children had significantly less weight loss compared to Caucasian children at 4-months and at 12-months. SES was not associated with differences in child %OV reductions.

Conclusions

Findings suggest that FBT is effective at producing child weight loss across different income, SES, and racial groups, but more work is needed to understand observed differences in efficacy and optimize treatment across all groups.