A UK-Based Specialist Children’s Weight Management Approach: Initial Outcomes from the Family Therapy Pathway
The family therapy-based programme supports children with obesity and complex needs through tailored one-on-one sessions. Case studies showed weight loss, improved sleep, and healthier habits, highlighting the value of psychological support in child weight management.
A UK-Based Specialist Children’s Weight Management Approach: Initial Outcomes from the Family Therapy Pathway
Kathryn Marshall, Dr Nadine Heywood, Dr AB Sirin-Ayva, Dr Sophie Edwards, Prof Paul Gately
Introduction
Today, nearly a third of children aged 2 to 15 are living with overweight or obesity, which has an impact on both physical and mental health. Morelife delivers tailored, evidence-based and psychologically informed specialist child weight management services (SCWMS) in the UK. Children living with obesity need support in gaining self-esteem and self-acceptance, and the higher risk of depression in children living with obesity or those who are overweight can be partially accounted for by their weight concerns, their perceived isolation from their peers and shame. Despite this, the majority of commissioned Specialist Child Management Services are highly medicalised, neglecting psychological support.
Methods
Morelife provides 6-9 sessions of 1-2-1 family therapy for families with complex medical, social and psychological needs to help them with healthy lifestyle changes to facilitate weight loss/maintenance. Weight, physical activity, diet and other lifestyle factors are monitored during the intervention, which lasts a year.
Results
Three families with children living with obesity and complex needs are presented in this evaluation. All 3 cases improved their physical activity levels and reduced their BMI.
Case A
Female, age 10.
She has blood conditions and is struggling with emotional eating and body image issues. During their time with Morelife, the family made many changes based on learning the traffic light system and portion control. Case A improved her physical activity levels, bedtime routine, and sleep quality, which helped her lose weight. The family stressed changing their eating habits, swapping for healthier options/smaller portions and low-calorie dishes, more vegetables and less carbohydrates. Her parents also cut down on fizzy drinks and alcohol, whereas Case A decreased the amount of snacks and sweets she was having. Case A stopped stress eating and became more active during the day. This is reflected in her sleep, which has improved. Total weight loss at the end of the programme is 6.8 kg, which is 10.54% of total body weight. Case A also improved her relationship with food and reduced emotional eating. Her family also mentioned that Case A is now involved with cooking and meal planning.
Case B
Male, age 15.
Has Autism Spectrum Disorder (ASD), learning difficulties, epilepsy and sensory issues. Case B also has sleep apnoea and unhealthy eating habits. He is living with his mother and sister. Case B and the family therapist worked on how to identify and express emotions, hunger, and fullness to identify physical hunger to make informed choices. During the family therapy process, Client B started to try new foods and textures, choosing sensible food portions, swapping with homemade healthy options, choosing healthy snacks, and implementing a regular eating pattern. Case B also improved his bedtime routine and sleep hygiene. Family therapy also helped his mother improve her parenting skills and relationship with Case B. Case B joined a gardening club and became more physically active and confident about his activities. Case B lost 9 kg, 6.87% of his total body weight, at the end of the programme
Case C
Female, age 11.
Struggles with joint hypermobility. Case C had some issues with her hormones, which were causing her mood swings. During the family therapy process, Case C learnt how to process her feelings and try alternative things when she gets angry. She knew how to deal with her anger and take more responsibility for her medication and food choices. Her family changed their plates with smaller ones to help Case C with portion control and give her the responsibility of arranging the portions for the other family members, such as her older brother, who is over 18. Case C also started to become more active. They created a structure around bedtime and family time before bedtime, which helped Case C to go to bed earlier. Case C lost 10 kg, 12.7% of her body weight. Her family shared healthy lifestyle changes, such as smaller portions, improved sleep, more family time, meal planning, batch cooking, and family exercise. All those changes reflect on children’s health and eating behaviours
Conclusion
This evaluation indicates that family therapy is a clinically and cost-effective way of supporting families of children with complex obesity. Feedback from families shows that families with complex needs benefit from therapy support and achieve behavioural changes whilst improving their parental skills, wellbeing and communication with their children. Future research is needed to assess the long-term impacts of family therapy and weight loss.