The risk of developing disordered eating following a family-based program among children with overweight and obesity and their siblings: Retrospective and prospective analyses.

Background: Studies have raised the concern that dieting and weight-loss programs may be a potential risk factor for developing eating disorders, and may have a potential to affect siblings as well. This study assessed the long-term risk of developing disordered eating among children with overweight and obesity and their siblings as well as the change in the obesogenic environment following a family-based intervention program.

Methods: In a 30-month retrospective follow-up study (n=18 families in intervention group, n=26 families in control group, total of 81 children and siblings) and a 14-month prospective follow-up study (n=42 families, 78 children and siblings), families with one or more children with overweight or obesity ages 8-14 years participated in a multidisciplinary parent-child program called "Maccabi Active". Children's version of the eating-attitude-test (ChEAT) questionnaire, family eating-and-activity-habits questionnaire (FEAHQ) and BMI z-score were measured.

Results: in the retrospective study, no difference between groups with respect to ChEAT scores in children and siblings was found. In the prospective study, the FEAHQ score significantly decreased after completion of the program (ΔFEAHQ=-16.2±4.9, p=0.001) and continued to decrease in the 8-month follow-up (ΔFEAHQ=-23.2±5.7, p=0.001). BMI z-scores decreased after 6 months (ΔBMI z-score=-0.3±0.1, p=0.014), and did not increase in the 8-month follow-up.

Conclusions: Our findings suggest no exacerbation in disordered eating behaviors among children with overweight or obesity or their siblings, thus alleviating concerns surrounding the development of disordered eating after participating in a family-based intervention. Moreover, improvement in obesogenic environment suggests potential benefits to the entire family.