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Childhood obesity in low-income Missouri families aim of CDC grant

$3.7 million will help evaluate Family-based Behavioral Treatment

by Jim DrydenSeptember 19, 2019

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Obesity researchers from around Missouri, led by scientists at Washington University School of Medicine in St. Louis, have received a grant to help evaluate and put in place family-focused weight-management programs designed to reduce childhood obesity, particularly among children from low-income families.

With a five-year, $3.7 million grant from the Centers for Disease Control and Prevention (CDC), the researchers will conduct one of the CDC’s Childhood Obesity Research Demonstration projects. The grant provides funding to study the effectiveness of Family-based Behavioral Treatment (FBT), especially in children from low-income families. FBT is a behavioral weight-loss program shown to help both children and parents lose weight and fight obesity.

In addition to the Washington University research team, the study involves researchers at Children’s Mercy and the Center for Children’s Healthy Lifestyles & Nutrition, both in Kansas City, and at the Freeman Health System in Joplin, Mo. The study includes investigators at the Pennington Biomedical Research Center at Louisiana State University in Baton Rouge, La., and at Northwestern University Feinberg School of Medicine in Chicago.

“Childhood obesity is a pressing public health concern,” said principal investigator Denise E. Wilfley, PhD, the Scott Rudolph University Professor of Psychiatry and director of the Washington University Center for Healthy Weight and Wellness. “Obesity rates have more than doubled in children and quadrupled in adolescents over the last 30 years. At present, nearly one in five children in Missouri has obesity, and alarmingly, children from low-income families have higher obesity rates than those from higher-income families. In this project, we’re studying the best ways to deliver the treatment to give larger numbers of children access to quality care.”

When left untreated, obesity puts kids at greater risk for problems that can negatively affect their overall health and quality of life. Although there are good, evidence-based treatments available for pediatric patients with obesity, Wilfley said relatively few children, particularly those from low-income households and racial minority groups, have access to the care they need.

“Our research has shown Family-based Behavioral Treatment is effective at decreasing weight and improving health and well-being,” said Wilfley, who also is a professor of medicine, of pediatrics, and of psychological & brain sciences, as well as a faculty scholar at Washington University’s Institute for Public Health. “We’ve demonstrated that the program can reduce obesity, improve nutrition and physical activity, and enhance psychosocial outcomes for kids.”

Wilfley

To increase the availability of FBT, the researchers are creating online and mobile platforms to train health-care providers to deliver the treatment and to provide families with resources, such as videos and virtual simulations that supplement the treatment.

Lack of insurance coverage has been a barrier for many families that could benefit from FBT. So Wilfley and a fellow investigator in this study, Sarah E. Hampl, MD, a professor of pediatrics at the University of Missouri-Kansas City School of Medicine, and their colleagues have pushed for new policies, eventually leading MO HealthNet — the Medicaid program for Missouri — to propose a new rule. That rule, expected to go into effect Jan. 1, 2021, will allow for reimbursement to health-care professionals who deliver this type of treatment to Medicaid recipients.

Researchers involved in the project also will work with organizations in Missouri and around the nation to extend the reach of FBT to other health-care systems and providers.

“This project is designed to serve as a model for other states that want to implement cost-effective, evidence-based treatments for pediatric obesity,” Wilfley said.

Hampl said the project has the potential to reduce the likelihood of other serious health problems in pediatric patients by making weight-management interventions potentially available to millions of children from low-income families.

“More than four of every five children we see for an initial weight-management visit already suffer from a medical complication of obesity,” Hampl said. “We are excited by the potential to address obesity with family-based treatment and, potentially, to prevent some of those other health problems from developing.”

For more information about CORD 3.0 awards from the Centers for Disease Control and Prevention, visit: https://www.cdc.gov/obesity/strategies/healthcare/cord3.html

Washington University School of Medicine’s 1,500 faculty physicians also are the medical staff of Barnes-Jewish and St. Louis Children’s hospitals. The School of Medicine is a leader in medical research, teaching and patient care, ranking among the top 10 medical schools in the nation by U.S. News & World Report. Through its affiliations with Barnes-Jewish and St. Louis Children’s hospitals, the School of Medicine is linked to BJC HealthCare.