Do School-Based Obesity Interventions Work?

In light of the increasing number of overweight and obese kids, demand and focus on obesity interventions aimed at school kids is increasing.

The questions, however, are:

1) is the school really the best place to intervene - or in other words, can the school compensate for poor environments in the home and the often poor parenting skills that may promote childhood obesity?

2) and perhaps more importantly, do school-based invterventions actually work?

The latter issue was recently studied by Jonathan Kropski and colleagues from the Vanderbilt Centre for Evidence-Based Medicine, Nashville, Tennessee in a paper just out in OBESITY.

Kropski and colleagues performed a systematic review of all research published on this issue since 1990 and found only fourteen studies that were of sufficient quality to draw any conclusions. These included one nutrition-only progam, two physical activity promotion inverventions and eleven studies that combined both nutrition and activity interventions.

Based on the quality and results of these studies, only one study was designated as providing strong (grade 4 = randomzed controlled trial) evidence for the prevention of excessive weight gain in girls. Four weaker studies (observational data) provided some evidence of efficacy in boys and girls. The rest of the studies provided even weaker evidence for significantly improving measures of dietary intake, physical activity or both.

The bottom line is that from the current data, no conclusive evidence can be drawn regarding either the benefit or lack thereof for school-based intervention programs. There is certainly no evidence whatsoever that school-based interventions will indeed translate into less overweight or obesity in young adults.

Does this mean we sit back and give up? Certainly not - however, we must realise that pouring all our money into school programs as our primary approach to taming the obesity giant is based more on wishful thinking than on hard evidence.

The authors believe that despite the rather poor body of evidence, schools will play an important role in stemming current trends in overweight and obesity in children - but that is exactly it - for now this is nothing more than a "belief".

Clearly, we need more high-quality studies to determine whether or not investing in school programs is indeed cost-effective.

My guess is that without parents taking on an active role and policy makers doing all they can to reduce our current obesogenic environment, schools will have little say in the matter - but of course, I am happy to be proven wrong.