The Lasting Impact of Early-Life Responsive Parenting on Childhood Weight

Childhood obesity remains a pressing public health issue in the United States, with over 22% of children between the ages of six and 19 classified as obese. While diet and exercise are often the focal points of obesity prevention efforts, a new study from the Penn State College of Medicine and the Center for Childhood Obesity Research at Penn State University suggests that responsive parenting during early childhood could play a critical role in shaping long-term weight outcomes.

Insights from the INSIGHT study

The research, part of the ongoing INSIGHT study, explored the effects of early-life parenting interventions on childhood weight. The study followed two groups of first-time mothers and their children from birth through age nine. One group received training on responsive parenting practices, which encouraged mothers to attune to their child’s emotional and physical needs, particularly in areas such as feeding, sleep, play, and emotional regulation. The control group, by contrast, received education on household hazard prevention.

Published in JAMA Pediatrics on March 10, 2025, the study builds upon previous findings that demonstrated a positive impact of responsive parenting on children’s weight through age three. The latest results show that children whose mothers received responsive parenting education had lower average body mass index (BMI) levels through middle childhood compared to their peers in the control group. Notably, the effects were more pronounced among female participants, indicating that this approach may be particularly beneficial for young girls.

The challenges of sustaining early gains

Despite the promising early outcomes, the study revealed that the benefits of responsive parenting interventions diminished over time, with BMI differences fading by age nine. Dr. Ian Paul, principal investigator and University Professor of Pediatrics at the Penn State College of Medicine, emphasized that while the intervention had a meaningful early impact, sustaining these effects in an environment that promotes unhealthy weight gain remains a challenge.

He said:

Our intervention stopped when the participating children were 2 years old and focused on the parenting of young children rather than behaviors and risk factors that emerge among school-aged children… While we are delighted that we made an impact early on, the fact that the beneficial effects disappeared by age 9 is not surprising, given the obesogenic environment we live in.

Dr. Jennifer Savage, another principal investigator and Director of Penn State’s Center for Childhood Obesity Research, echoed this sentiment, highlighting the importance of ongoing support for families beyond early childhood.

A call for a life-course approach

The study’s findings reinforce the notion that diet and exercise alone are not enough to combat childhood obesity. Instead, responsive parenting practices may help establish healthy growth patterns that reduce the risk of obesity as children grow. However, to sustain these benefits, researchers advocate for a broader, life-course approach that includes continued support for healthy habits throughout childhood and adolescence.

By integrating responsive parenting strategies into early childhood care and complementing them with ongoing reinforcement, healthcare providers, educators, and policymakers can help foster healthier futures for children. As this research suggests, equipping parents with the tools to respond to their child’s developmental needs may be an essential component of long-term obesity prevention efforts.

Your responses and feedback are welcome!

Source: “Early-life responsive parenting intervention yields lasting but diminishing benefits on child weight,” Penn State Health News, 3/10/25
Source: “Long-Term Effects of a Responsive Parenting Intervention on Child Weight Outcomes Through Age 9 Years,” JAMA Pediatrics, 3/10/25
“Effect of a Responsive Parenting Educational Intervention on Childhood Weight Outcomes at 3 Years of Age: The INSIGHT Randomized Clinical Trial,” PubMed, 8/7/18
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A “Strong” Study Looks at Pediatric Obesity Treatment

Children who respond positively to pediatric obesity treatment show significantly lower risks of health problems and early death in young adulthood, according to a study published on January 21 in JAMA Pediatrics.

The gist of the study

Led by Resthie R. Putri, Ph.D., and a team from the Karolinska Institutet in Stockholm, Sweden, the researchers analyzed data from 6,713 children and adolescents with obesity, drawn from Sweden’s Childhood Obesity Treatment Register (BORIS) and compared them to general population data. The study used baseline information collected between 1996 and 2019 and analyzed outcomes in 2023.

Study’s results

The study tracked health outcomes for young adults, ages 18-30, from 2005 to 2020. The participants included children aged 6-17 who had received at least one year of obesity treatment. These individuals were compared to a group from the general population matched for sex, birth year, and geographic location.

The research team categorized the participants’ responses to obesity treatment based on changes in their body mass index (BMI) standard deviation scores. These categories included poor, intermediate, good, or remission of obesity. Health outcomes in young adulthood that were assessed included type 2 diabetes, dyslipidemia, hypertension, depression or anxiety, and the need for bariatric surgery.

The findings showed that compared to a poor treatment response, those who achieved obesity remission or had a good treatment response were at much lower risk for early death. Additionally, a good response was linked to a lower likelihood of developing type 2 diabetes, dyslipidemia, and requiring bariatric surgery. Only the remission group showed a reduced risk for hypertension. However, treatment response did not appear to influence the risk of depression or anxiety, a noteworthy observation as it suggests that these mental health conditions need to be addressed separately from obesity.

The study’s large sample size and Sweden’s universal healthcare system, which facilitated continuous data tracking, were key strengths. The authors noted that the results may not be applicable to other countries, as the study’s findings are based on Swedish data.

The commentary

One of the study’s authors, Emilia Hagman, who is a principal researcher at the Department of Clinical Science, Intervention and Technology, Karolinska Institutet, commented:

The results are very good news. Whether or not the treatment of obesity in childhood has long-term health benefits has been debated, since weight-loss is hard to maintain… This emphasizes the importance of providing early treatment, as we know that timely intervention increases the likelihood of success and helps mitigate the long-term health risks associated with obesity.

In an accompanying commentary, Leonard H. Epstein, Ph.D., and colleagues praised the study for its robust design and the insights it offers into how much weight change is needed for significant health improvements, which could inform future treatment guidelines. However, they pointed out that the study didn’t specify the types or intensity of treatment provided to the children, which makes it difficult to compare with U.S. guidelines from the American Academy of Pediatrics (AAP).

The commentary also highlighted a key finding: Younger children (ages 6-11) had a higher rate of achieving good responses or remission compared to adolescents (ages 12-17). This suggests that earlier intervention in childhood may lead to better outcomes, emphasizing the importance of starting obesity treatment early rather than waiting to see if the child will “outgrow” the condition.

The bottom line

The study also found no strong connection between obesity treatment response and anxiety or depression, thus suggesting that these conditions should be treated independently of obesity. The study provides important evidence on how pediatric obesity treatment affects long-term health, including risks for cardiometabolic diseases, the need for bariatric surgery, and even mortality. This information is vital for refining clinical guidelines and improving obesity treatment strategies.

Your responses and feedback are welcome!

Source: “Successful Pediatric Obesity Treatment Linked With Long-Term Health,” Medscape, 1/22/25
Source: “Effect of Pediatric Obesity Treatment on Long-Term Health,” JAMA Network, 1/21/25
Source: “Weight-loss treatment for children with obesity has lasting effects, finds study,” MedicalXPress, 1/21/25
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Trauma Doubles the Risk for Obesity, But It Can Be Helped

Unsurprisingly, children who face trauma early in life are at a higher risk of becoming obese, but new research suggests that positive experiences can help reduce this risk. A new article in The Conversation discusses the research and throws some light on what could be done to reverse or improve the situation.

Childhood trauma is unfortunately widespread. A study of nearly 5,000 children in New Zealand found that 87% had experienced at least one major traumatic event by age eight, and about a third (32%) had endured three or more. Traumatic experiences can range from physical and emotional abuse to exposure to bullying, domestic violence, substance abuse, mental illness, parental incarceration, divorce, or discrimination.

Children from lower-income families, as well as Māori and Pasifika children, were particularly affected by multiple types of adversity and had higher rates of trauma overall.

The consequences of these early experiences are significant. Children who had at least one traumatic event were twice as likely to be obese by age eight, with the likelihood increasing with the number of adverse experiences. Children who had four or more traumatic events were nearly three times more likely to be obese. Certain types of trauma, such as physical abuse and exposure to domestic violence, were more strongly linked to obesity, emphasizing the connection between early adversity and physical health.

One possible explanation is that stress from these traumatic experiences contributes to emotional distress, which may lead children to adopt unhealthy behaviors such as overeating, poor diet choices, lack of sleep, too much screen time, and physical inactivity. The study found that children who had faced adversity were more likely to engage in these behaviors, which in turn raised their risk of obesity.

However, the research also highlighted a hopeful finding: Positive experiences can help counteract some of the negative effects of trauma.

Positive experiences included things like:

• Parents in stable relationships
• Mothers having positive interactions with their children
• Children involved in community activities, like visiting museums or participating in sports
• Families with structured routines for bedtimes, screen time, and mealtimes
• Access to quality early childhood education

The study found that children who had more positive experiences were significantly less likely to be obese. For instance, children with five or six positive experiences were 60% less likely to be overweight or obese compared to those with no or just one positive experience. Even having two positive experiences reduced the likelihood of obesity by 25%.

To offset the impact of trauma, a minimum of four positive experiences was necessary. Although nearly half of the children in the study had at least four positive experiences, a concerning number (more than 10%) had very few positive experiences at all.

The key takeaway is that traditional weight-loss programs focusing solely on behavior change are insufficient. A more holistic approach is needed, one that addresses the social, emotional, and environmental factors contributing to childhood obesity. Fostering positive experiences is critical, as they not only protect children from the harmful effects of trauma but also promote overall physical and mental well-being.

For vulnerable children, creating supportive environments is essential. Policymakers, schools, and families all have a role to play. Community programs such as after-school activities, healthy relationship initiatives, and mental health services can provide crucial support. A trauma-informed approach, particularly for children from disadvantaged backgrounds, is essential to address the impacts of domestic violence and other traumatic events.

Families can help by creating stable routines, engaging in social networks, and involving children in enriching activities. Schools and early childhood education providers also play a vital role in helping children build resilience and recover from trauma. Policymakers must invest in programs that provide positive experiences, helping to level the playing field for children who are at greater risk due to their circumstances.

When positive experiences outweigh the negative, children have a far greater chance to thrive physically, emotionally, and socially.

Your responses and feedback are welcome!

Source: “Children with traumatic experiences have a higher risk of obesity — but this can be turned around,” The Conversation, 1/13/25
Source: “Identification of positive childhood experiences with the potential to mitigate childhood unhealthy weight status…,” BMC Public Health, 1/13/25
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E-Health and Social Media Studies in the News This Week

We’ve discussed before how e-health and telehealth can be effectively used to combat childhood obesity in conjunction with other interventions. This week, in the news, there were two studies that seemed of interest. One was an Australian study involving kids ages 7-13 and dealt with e-health (electronic health) intervention, and another looked at the connection between social media use and binge eating behaviors in adolescents.

The purpose of the e-health study

E-health interventions have the potential to enhance the effectiveness of traditional, in-person treatments for childhood obesity. This study assessed the impact of a 10-week, web-based healthy lifestyle program designed for school-aged children with overweight or obesity. The results were published in BMC Public Health this week.

Methods of the study

This randomized controlled trial (RCT) involved families with children aged 7–13 years, living in Victoria, Australia, who had a body mass index (BMI) at or above the 85th percentile (indicating overweight or obesity). Families were randomly assigned to either the intervention group or a waitlist control group and participated in the 10-week web-based program. The primary outcome was the change in the children’s BMI scores over the 10 weeks. Secondary outcomes included changes in waist circumference, dietary habits, physical activity, and quality of life over the same period.

In the intervention group, families accessed weekly modules on a secure website, covering topics such as healthy eating, physical activity, and family-centered behavior changes. Each week, families had phone sessions with a health professional coach (e.g., dietitians, nutritionists, or exercise physiologists), during which they discussed the week’s content and confirmed the completion of activities. The program also included interactive elements like online quizzes and goal-setting exercises to help families implement lifestyle changes.

The study results

Out of 148 children (125 families) recruited, 102 children (85 families) completed the trial. The intervention group showed a significant reduction in BMI scores compared to the control group after 10 weeks. The web-based program also led to improvements in children’s quality of life and lifestyle behaviors. In the intervention group, there were significant improvements in quality of life scores, overall diet quality, and daily physical activity levels compared to the control group.

Why it matters

A web-based healthy lifestyle program was effective in improving short-term health outcomes for children with overweight or obesity. Future research should focus on identifying factors that contribute to the program’s effectiveness, assessing its long-term impact, and ensuring the program is adapted to meet the needs of diverse populations.

Social media’s impact on binge eating, a study

Dr. Susan Carnell, an associate professor in the Division of Child and Adolescent Psychiatry at Johns Hopkins University School of Medicine, recently spoke about her research on the connection between social media use and binge eating behaviors in adolescents. Carnell is a co-author of the study, “Concurrent and prospective associations of social media usage with binge eating symptoms in early adolescence,” published in Obesity and highlighted this week in Contemporary Pediatrics. The article included an interview with Dr. Carnell conducted by the article’s author, Joshua Fitch, Senior Editor of Contemporary Pediatrics.

Dr. Carnell and her team wanted to investigate how social media might influence eating disorders, particularly by examining the role of social comparison and certain content that could lead to body dissatisfaction. The study used data from the Adolescent Brain Cognitive Development (ABCD) study, a large, ongoing project that tracks children across 21 sites in the U.S.

Dr. Carnell said:

The study began by recruiting children around 9 to 10 years old, and we’ve been following them ever since… This allowed us to analyze the relationship between social media use, how much time kids spent on it, and whether they exhibited addictive behaviors related to social media.

Carnell observed that social media use increased with age:

At ages 11 to 12, kids spent an average of about an hour per day on social media, and by adolescence, that rose to over two hours… For those who developed persistent binge eating, however, social media use went up to more than three hours a day.

Interestingly, the study found a key difference. To quote Dr. Carnell one more time,

We didn’t find that simply spending more time on social media was linked to binge eating. However, adolescents who showed high levels of addictive behaviors around social media at the start of the study were about 3.5 times more likely to develop binge eating by ages 14 to 15.

Carnell’s research underscores the importance of addressing addictive social media behaviors to help reduce the risk of eating disorders in adolescents. While the amount of time spent on social media isn’t inherently harmful, compulsive and addictive patterns of use can increase the likelihood of disordered eating behaviors.

Your responses and feedback are welcome!

Source: “The effectiveness of a 10-week family-focused e-Health healthy lifestyle program for school-aged children with overweight or obesity: a randomised control trial,” BMC Public Health, 1/7/25
Source: “Social media use and binge eating in early adolescence,” Contemporary Pediatrics, 1/6/25
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