Research just published on bmj.com reports that current primary care policies aimed at reducing obesity and increasing physical activity in children are very costly to run and not successful.

In a number of countries including the UK, US and Australia, family doctor screening and brief counseling is part of national policy to deal with childhood obesity. The programs are not harmful for the children, but research led by the Murdoch Children’s Research Institute in Melbourne, Australia, questions whether resources would be better spent on prevention and improving treatment for obesity.

“The global long-term physical, emotional, social, reproductive and economic consequences of childhood obesity are likely to be extremely serious,” says the study. This has led many countries to promote screening and counseling programs designed for children. “However”, say the authors, “very little evidence exists to show this kind of intervention works”.

Lead author, Professor Melissa Wake of the Royal Children’s Hospital and Murdoch Children’s Research Institute in Melbourne implemented a large trial (LEAP 2) that assessed the effectiveness of this anti-obesity approach in overweight and obese children.

The team of researchers surveyed nearly 4,000 children who visited their GP between May 2005 and July 2006. More than 250 overweight or mildly obese children were then selected to be part of the trial, from which 139 were entered into the intervention group and 119 into the control group. Participants in the intervention group received counseling over a twelve week period. Their families got assistance to set goals that focused on changing eating habits and increasing physical activity.

Parents reported that children in the intervention group drank fewer soft drinks. However, there were no noteworthy changes in the amounts of fruit, vegetables, fat or water consumed. In addition, there were no major differences in body mass index (BMI), overall nutrition and physical activity.

The authors write in conclusion that “brief, physician-led primary care intervention produced no long-term improvement in children’s BMI, physical activity or nutrition” and they continue by saying that “resources may be better divided between primary prevention at the community and population levels, and enhancement of clinical treatment options for children with established obesity.”

“Outcomes and costs of primary care surveillance and intervention for overweight or obese children: the LEAP 2 randomised controlled trial”
Melissa Wake, paediatrician, Louise A Baur, professor, Bibi Gerner, research officer, Kay Gibbons, head of Nutrition and Food Services, Lisa Gold, health economist, Jane Gunn, professor, Penny Levickis, research assistant, Zoe¨ McCallum, paediatrician, Geraldine Naughton, director, Lena Sanci, research fellow, Obioha C Ukoumunne, statistician
BMJ 2009; 339:b3308
bmj.com

Written by Stephanie Brunner (B.A.)