Family Dynamics and Pediatric Weight Management: Putting the Family into Family-Based Treatment
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CHILDHOOD OBESITY (A KELLY AND C FOX, SECTION EDITOR)
Family Dynamics and Pediatric Weight Management: Putting the Family into Family-Based Treatment Joseph A. Skelton 1,2
&
Catherine Van Fossen 3 & Onengiya Harry 1,2 & Keeley J. Pratt 3,4,5
Accepted: 5 October 2020 # Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Purpose of Review The treatment of pediatric obesity entails working with entire families. However, aside from parenting and family health behaviors, family dynamics and relationships are not often incorporated in clinical treatment of obesity. Recent Findings Evidence across several studies suggest a relationship between family dynamics and child weight, with impaired family dynamics associated with higher weight status in children. Evidence is mixed if child age and family function are associated. Unfortunately, there is little evidence that addressing family dynamics (i.e., relationships and overall family system) will improve weight in children with obesity. Notably, few studies target family dynamics specifically. There are several validated measures of family dynamics available for researchers to explore the family system as it relates to child health and behaviors. Summary A deeper understanding of family dynamics and relationships may provide new avenues to address issues of weight in children; accounting for the family, and their underlying functioning, may benefit the clinician and child engaged in weight management. Keywords Obesity . Pediatric . Family dynamics . Family function . Treatment
Case Study A 12-year-old female and her mother scheduled a visit with their pediatrician to discuss the child’s weight. Since age five, the patient had experienced steady weight gain and was now
This article is part of the Topical Collection on Childhood Obesity * Joseph A. Skelton [email protected] 1
Department of Pediatrics, Wake Forest School of Medicine, Medical Center Blvd., Winston-Salem, NC 27157, USA
2
Department of Epidemiology and Prevention, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC, USA
3
Department of Human Sciences, Human Development and Family Science Program, College of Education and Human Ecology, The Ohio State University, Columbus, OH, USA
4
Department of Surgery, The Ohio State University Wexner Medical Center, Columbus, OH, USA
5
Department of Pediatrics, The Ohio State University, Columbus, OH, USA
in the category of severe obesity with a BMI 144% of the 95th percentile. She was otherwise well with no significant medical problems besides seasonal allergies, for which she took a leukotriene inhibitor to control. Her mother is most concerned about her diet: she did not eat breakfast most days (said she was not hungry), ate lunch at school, and periodically had snacks at home late in the afternoon. The family was “on the go” most evenings, eating meals away from home three to four times a week, usually fast-food or fast-casual restaurants. She drank regular sodas when eating out, but only water
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