$12.7 million grant for study of childhood obesity treatment

Steve Fisch

Thomas Robinson will use his new funding to find ways of making weight control fun for kids.

In a new effort to combat childhood obesity, the National Institutes of Health has announced that researchers at Stanford University and Lucile Packard Children’s Hospital have been awarded a $12.7-million, seven-year grant to design a pediatric weight-control program that could be used across the country.

The research team, led by Thomas Robinson, MD, MPH, the Irving Schulman Endowed Professor of Child Health and professor of pediatrics and of medicine at the Stanford University School of Medicine, received the award as part of the NIH’s new $49.5 million Childhood Obesity Prevention and Treatment Research program. Scientists at three other sites — Vanderbilt University, Case Western Reserve University and the University of Minnesota-Twin Cities — also received COPTR grants.

“Our study will test a very exciting new model for treating overweight and obese kids,” Robinson said. “Currently, most communities have few resources to help these children and their families.”

Robinson directs the Center for Healthy Weight at Packard Children’s Hospital. The center’s intensive, six-month pediatric weight-control program has a great track record: More than 80 percent of participants succeed in reducing their excess weight. But most of the nation’s overweight children lack access to an equivalent program. Instead, their weight-loss care might be limited to a few pediatrician or dietitian visits a year.

“Traditional medical care doesn’t address obesity particularly well,” Robinson said. “It’s geared toward the medical aspects of problem, not its behavioral or environmental components. This grant is an opportunity to say, ‘What if we start from scratch with a new model? How would we build a treatment program that uses existing resources in the medical care system, the community and families to approach childhood obesity?’”

The new study will incorporate strategies developed in some of Robinson’s previous research on ways to make weight control fun. For instance, overweight children enjoy and benefit from soccer teams and dance classes organized just for them, his team has found, even if they feel too self-conscious to participate in physical activities with normal-weight peers.

“We’ve found that kids are intrinsically motivated to adopt healthful behaviors when the change is fun, gives them a sense of choice and control and provides challenges and a sense of accomplishment,” Robinson said. “We’re building upon those findings for our new program.”

In the new study, overweight and obese children will get diagnostic evaluations and medical attention from their existing primary care providers; learn healthy eating and exercise habits in specially-designed community after-school programs; and receive home visits to make their living spaces conducive to weight loss. After two years of development and pilot tests, the researchers will test the program with 240 obese 7- to 12-year-olds and their families. Each family will receive treatment for three years. Half will receive the new treatment program; the remaining participants will receive standard-of-care treatment plus an after-school program. The analysis will include evaluation of the program’s cost-effectiveness. It will be one of the longest and largest studies ever conducted on childhood obesity treatment.

“It’s a really unusual opportunity to receive this much funding and time to develop and test a new model of care,” Robinson said. “We’re very excited that we will get to extend the capabilities of primary care professionals, leverage community resource, and provide individualized family- and home-based services where kids live.”

Robinson’s team of Stanford collaborators includes national experts in such fields as psychology, nutrition, exercise science, health policy, genetics, endocrinology and statistics. His co-investigators are Jay Bhattacharya, MD, PhD, associate professor of medicine at the Center for Primary Care and Outcomes Research; Manisha Desai, PhD, clinical associate professor of medicine and director of the Quantitative Sciences Unit; William Haskell, PhD, professor emeritus of medicine at the Stanford Prevention Research Center; Mark Lepper, PhD, professor of psychology; Donna Matheson, PhD, senior research scholar in medicine; Samuel McClure, PhD, assistant professor of psychology; Greer Murphy, MD, PhD, professor of psychiatry and behavioral sciences; Dana Weintraub, MD, clinical assistant professor of pediatrics; Darrell Wilson, MD, professor of pediatric endocrinology; and Paul Wise, MD, MPH, professor of pediatrics and of health research and policy.