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Fitness Through Family

New research suggest improveing family interactiions may play a role in reducing obesity among children and teens

Innovations in Pediatrics - Summer 2016 - View Full PDF

Carolyn E. Ievers-Landis, PhD


There’s no shortage of programs and proposals to address the rising rates of overweight and obesity among American children and teens. Although many have had limited results, new research suggests a potential way to boost success. The intervention? Targeting the dynamics of the child’s family environment.

Carolyn E. Ievers-Landis, PhD, a child psychologist at University Hospitals Rainbow Babies & Children’s Hospital, and colleagues studied 108 adolescents enrolled in a multidisciplinary pediatric weight management program, exploring how self-efficacy, self-esteem and family relationship dynamics related to participants’ overall fitness level.

They found that family factors such as cohesion, expressiveness and conflict played an important role in the variables associated with overall health. The group recently published its results in the journal Childhood Obesity.

“What’s important about these findings is that they show that how families function affects children’s health,” Dr. Ievers-Landis says. “How well families can work together, communicate and work through problems relates closely to health behaviors, especially for children who are overweight or obese.”

The research team found that self-esteem and self-efficacy – kids’ belief that they can overcome barriers to being physically active – were strongly associated with the dynamics of their families. Higher scores on family conflict were associated with both lower self-esteem and lower self-efficacy among children and teens. At the same time, higher family cohesion and expressiveness were related to greater self-efficacy and physical fitness.

For Dr. Ievers-Landis, this makes good sense.

“If you have a family that works together, communicates and deals with conflict, then when there is a barrier to exercise, kids are better able to overcome it,” she says. “Having a family that functions well also affects how kids feel about themselves. That translates into them taking care of themselves and being able to go the extra mile.”

According to Dr. Ievers-Landis, an increasing number of weight loss programs for kids and teens are taking a “family therapy” type of approach. With her group’s and other recent research findings confirming the importance of family dynamics, she says she expects the trend to continue.

“We’ve always had parents involved in our weight loss programs for kids and teens, but more from the perspective of supporting their kids and serving as good role models,” she says. “But now we’re looking at how the family functions. We’ve done this with kids with depression and anxiety, but it also might make sense for families of children who are overweight or obese. It’s been so hard to find something to help these kids, but interventions using clinical therapy frameworks like Behavioral Family Systems Therapy (BFST) that teach positive communication strategies and give practice in problem-solving may help ensure that the family is working together as optimally as possible to help their child who is overweight or obese.”

For more information on this study, email