Objective. The current study examined the use of stimulus control, self-monitoring, and reinforcement by youth, parents, and interventionists as related to weight management in lifestyle intervention programs. Design. Secondary analysis of an existing data set was used to integrate the results of 14 published, randomized treatment–control intervention trials for overweight youth aged 2 to 18 years. Main outcome measure. Between-group differences in weight-related outcomes, including weight, body mass index (BMI), and percentage overweight, measured at the end of treatment, were used to calculate effect sizes for each treatment–control comparison. Additionally, average effect sizes were calculated among sets of comparisons sharing similar approaches to implementing behavioral techniques. Results. Treatment programs that taught youth to use stimulus control, taught youth to self-monitor, and taught parents to use reinforcement, produced significantly larger effect sizes than programs that did not include these components. The beneficial effects of these specific behavioral techniques appeared to be amplified when used with multiple key individuals. Conclusion. This initial study quantitatively demonstrated significant benefits associated with teaching youth stimulus control and self-monitoring, and teaching parents reinforcement to shape health behaviors in lifestyle interventions for pediatric overweight. Furthermore, teaching youth and parents the same techniques may contribute to better weight-related outcomes. These findings and descriptive information on how techniques were described, taught, and delivered may guide future research efforts aimed at identifying and examining the most effective behavioral components to include in brief interventions.

Parent involvement has been recognized as a promising component in the treatment of pediatric overweight. However, to what extent and how to involve parents remains unclear. Family systems models have been used to treat a range of childhood illnesses and may also provide a useful framework for understanding and treating pediatric overweight. The current review presents relevant literature on family systems and child health, discusses the current state of intervention efforts in pediatric overweight, and utilizes family systems ideas to offer suggestions for practice and directions for research regarding the role of parents in treatment.

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