Online weight-loss study seeks to educate parents of overweight 2- to 6-year-olds

Obesity researchers at Washington University School of Medicine in St. Louis are recruiting families for an on-line program aimed at young children that targets healthy eating and physical activity.

The 10-month study will evaluate the effectiveness of Food for Thought, an investigational, Internet-based program for parents of overweight 2- to 6-year-olds.

“The computer intervention teaches parents and caregivers to provide healthy food and activity choices for their children,” says Denise E. Wilfley, Ph.D., the study’s principal investigator. “Children in this very young age group already are drinking sugar-sweetened beverages. They’re watching television, which exposes them to food industry advertising and conditions them to want food and drinks that often aren’t healthy. It can be hard for parents to reason with a screaming three-year-old in the cookie aisle at the supermarket, but this program can help parents who want to make healthier choices.”

Obesity is a problem for many Americans, including young children. About one-fifth of U.S. children are either overweight or obese, and that puts them at very high risk for obesity as adults. Among those who are overweight, 65 percent of white girls, and 84 percent of black girls grow up to be obese women. Some 71 percent of overweight white boys and 82 percent of overweight black boys become obese men.

As children grow into overweight and obese adults, they face mounting medical complications such as diabetes, high blood pressure and heart disease. Studies have shown that because they naturally grow taller, young children can get leaner even if they don’t drop that many pounds. By intervening at younger ages, the investigators believe it may be easier to alter a child’s activity patterns and dietary habits so that young children may develop long lasting healthy eating and activity behaviors. But young children don’t have the power to control their own environment, so parents are the cornerstone of the program.

“Food for Thought encourages parents to change the structure of their own eating and activity patterns,” says Wilfley, a professor of psychiatry, medicine, pediatrics and psychology. “There are some data to suggest that as parents increase their intake of fruits and vegetables, children will eat fewer so-called ‘red foods,’ calorie-dense and non-nutritious things such as fried foods, sugar-sweetened beverages, chips and cheese doodles.”

Wilfley admits it may seem odd to ask people to sit at a computer to lose weight, but she says previous Internet-based treatments for overweight and obese adults and adolescents have worked. She also has used web-based interventions successfully to treat people with eating disorders. What is different about this intervention is that it targets such young children. The program also is intended to be convenient for parents and caregivers because they have access to the material whenever they have the time and do not have to worry about travelling to a weekly clinic appointment.

The Food for Thought program lasts 16 weeks. Parents are asked to log on to a website for about an hour each week for 12 weeks. The website provides tips and strategies to help parents and children eat less and exercise more. Parents also are asked to monitor their child’s eating and activity throughout the week and to weigh themselves and their children at least once each week.

“They look at whether their child’s weight has changed,” Wilfley explains. “We don’t want them to view that weekly weight in a punitive way but just as a way to brainstorm about what dietary and behavior patterns are working and what may not be working so well. One exciting aspect of the program is the inclusion of practical ideas, such as child-friendly recipes and information about how to access healthy eating and activity resources in the St. Louis area.”

The investigators plan to recruit 60 families with overweight children. All must have regular access to the Internet. Study participants will be asked to come to Washington University Medical Center three times for one-hour clinical assessments: an initial evaluation at the start of the study, a second assessment after four months to determine whether children have lowered their body mass index and a final assessment after another six months to see whether the children maintain successes or revert to previous habits and obesity levels.

Half of the families in the study will be randomly assigned to the investigational Food for Thought intervention. The rest will visit a more general, healthy-living website called Bright Futures, which was put together by the American Academy of Pediatrics. If the Food for Thought intervention proves to be more successful at helping children lower their relative body mass indices, families who originally were assigned to visit the Bright Futures website will be given a chance to go through the Food for Thought intervention.

The program is provided free of charge for those who qualify, and families who complete the study will receive financial compensation. The study also provides childcare during clinic visits.

For more information, call study coordinator Anna Vannucci at (314) 286-1886 or e-mail


Washington University School of Medicine’s 2,100 employed and volunteer faculty physicians also are the medical staff of Barnes-Jewish and St. Louis Children’s hospitals. The School of Medicine is one of the leading medical research, teaching and patient care institutions in the nation, currently ranked third in the nation by U.S. News & World Report. Through its affiliations with Barnes-Jewish and St. Louis Children’s hospitals, the School of Medicine is linked to BJC HealthCare.