Evidence-based wellness program contributes to clinically significant weight reduction and quality of life improvements in overweight and obese children and teenagers
Community-based program can be scaled nationally to meet need for effective, accessible and affordable childhood obesity treatment
Research published today in the journal Pediatrics (October 2012) illustrates that JOIN for MESM, a community-based pediatric obesity lifestyle intervention program developed by UnitedHealth Group, resulted in clinically significant reduction in excess weight and improved health-related quality of life among overweight and obese children.
The program also resulted in small, statistically significant reductions in weight for parents of participating children, opening the door for a new wellness model that engages the entire family.
The six-month pilot study provides evidence that the JOIN for ME program has the potential to be impactful if scaled nationally to meet the critical need for effective, accessible and affordable treatment for childhood obesity.
JOIN for MESM, which was piloted with the YMCA of the USA and the YMCA of Greater Providence, R.I., engaged overweight and obese kids ages six to 17, along with their parents, in a series of learning sessions to achieve healthier weights through balanced nutrition choices, increased activity, and lifestyle-improvement tracking.
Obese and overweight status is measured using age- and sex-specific Body Mass Index (BMI) percentiles, which are calculated using a child’s weight and height. Being overweight is defined as a BMI at or above the 85th percentile and lower than the 95th percentile.[i] Obesity is defined as a BMI at or above the 95th percentile.[ii] More than 90 percent of the children who participated in the JOIN program were obese, and almost half were at or above the 99th percentile.
After six months, 84 percent of the original 155 participants in the JOIN for ME pilot completed the full program and achieved, on average, a 3.4 percent reduction in excess weight. Children under age 13 had a 4.3 percent reduction in excess weight, compared to children over 13 years of age, who experienced a 1 percent reduction. The researchers also found that 8 percent fewer children were at or above the 99th percentile and 10 percent fewer were in the obese category.
The study also revealed significant improvements in child health-related quality of life (measured by the 23-item Pediatric Quality of Life Inventory) as reported by both children and parents, and that the participants who attended a higher number of face-to-face group sessions experienced greater weight loss. Parents of participants in the study also experienced small, but statistically significant, reductions in weight.
“Our study showed a statistically significant improvement in weight outcomes among participants. Equally important, 10 percent fewer children were obese after the program, which means that, if scaled nationally, this program offers the potential to make tremendous health and economic impacts,” said Gary Foster, Ph.D., professor of Medicine and Public Health and director of the Center for Obesity Research and Education at Temple University and lead author of the Pediatrics article.
“The dilemma for practicing pediatricians is that the existing examples of effective clinic-based childhood obesity programs typically have limited reach and high cost, making them prohibitive to most families. JOIN for ME addresses these issues by emphasizing accessibility, affordability and effectiveness,” Foster said.
“We developed JOIN for ME to address the need for a low-cost, scalable and effective childhood obesity intervention that can be delivered to a much larger group of families than traditional, hospital-based interventions. We are gratified that this study shows it is very promising,” said Deneen Vojta, M.D., a physician executive at UnitedHealth Group and one of the study’s principal investigators, citing statistics from the Centers for Disease Control and Prevention (CDC). “The interventions that exist in the market today are generally hospital-based, individual treatment solutions that cost several thousand dollars per patient.”
JOIN for ME is an innovative childhood obesity program that builds a network of family support for children who struggle with extra weight. In the JOIN for ME program, a child and parent participate together. Tackling the epidemic for families means working from the ground up to drive small but meaningful changes in daily lifestyle choices for the whole household. JOIN families engage in evidence-based classes with the goal of achieving healthier weight through food-tracking, calorie goals, healthier family food choices, increased activity, decreased screen time and improved sleep habits.
UnitedHealthcare will offer JOIN for ME as part of the preventive care schedule for participants enrolled through employer-provided health insurance plans or government-sponsored Medicaid managed care plans in select markets. This means dependents of eligible employees or beneficiaries will have access to a community-based program to help them achieve healthier weight, while employers or plan sponsors will be supporting better health for participating families, potentially leading to lower health care costs due to fewer doctor and hospital visits.
JOIN for ME is one of UnitedHealth Group’s many community-based partnerships, wellness programs and health plan designs that are offered at no additional cost to members as part of their health plan benefits and encourage and empower people to take preventive steps and lead healthier lives.
Curbing a Growing Epidemic
About one-third of all American children are obese or overweight, leading to increased health risks, higher health care costs and decreased parental productivity at work, according to the CDC. Obesity now affects 17 percent of all children and adolescents in the United States – nearly triple the rate from just 30 years ago – according to the CDC.
Weight problems often lead to more serious health consequences. Obese children are more likely to have high blood pressure, high cholesterol and type 2 diabetes, all of which are risk factors for cardiovascular disease, according to the CDC. Obese children and adolescents also have a greater risk of social and psychological problems, such as discrimination and poor self-esteem, which can continue into adulthood.[iii, iv]
Childhood obesity also represents a significant financial cost to families, communities, employers and the health care system. A study conducted for one large employer indicated that average per capita health insurance claims costs were as high as $2,907 in 2008 for an obese child and $10,789 for a child with type 2 diabetes, which is even higher than the average claims cost for adults with type 2 diabetes ($8,844).[v]
How JOIN for ME Works
Based on these strong study results, UnitedHealth Group is currently working with community partners to expand the program nationally, and several state customers have signed on, including Texas, Rhode Island and pilot sites in Louisiana for children who are Medicaid beneficiaries.
JOIN for ME is a 12-month, community-based lifestyle-improvement program for children between the ages of six and 17 who are overweight or obese. Children and a parent attend a series of 16 weekly, one-hour group classes at local Ys in Providence, Boys & Girls Clubs or other community locations. Participants are introduced to evidence-based tools and strategies, as well as incentives to adopt healthier habits that lead to lifelong healthier weight. Sessions are led by a trained facilitator and cover topics such as reducing less healthy foods and drinks, getting and staying active, managing screen time, improving sleep habits, and understanding the link between moods and foods. After 16 sessions, kids and parents are encouraged to attend monthly maintenance sessions for an additional eight months.
The JOIN for ME pilot was designed to provide affordable and accessible care in local communities. JOIN for ME focuses on helping children who struggle with extra weight, underscoring the importance of cultivating a healthier environment and healthier behaviors at home with the entire family. To read the article in Pediatrics, click here.
About UnitedHealth Group
UnitedHealth Group (NYSE: UNH) is a diversified health and well-being company dedicated to helping people live healthier lives and making health care work better. With headquarters in Minnetonka, Minn., UnitedHealth Group offers a broad spectrum of products and services through two distinct platforms: UnitedHealthcare, which provides health care coverage and benefits services; and Optum, which provides information and technology-enabled health services. Through its businesses, UnitedHealth Group serves more than 75 million people worldwide. Visit www.unitedhealthgroup.com for more information.
iBarlow SE and the Expert Committee. Expert committee recommendations regarding the prevention, assessment, and treatment of child and adolescent overweight and obesity: summary report. Pediatrics 2007;120 Supplement December 2007:S164—S192.
iiiDietz W. Health consequences of obesity in youth: Childhood predictors of adult disease. Pediatrics 1998;101:518—525.
ivSwartz MB and Puhl R. Childhood obesity: a societal problem to solve. Obesity Reviews 2003; 4(1):57—71.
vSepulveda MJ, Tait F, Zimmerman E, Edington D. Impact of childhood obesity on employers. Health Affairs 2010; 29:513-521.