617 - Piloting Family-Based Time Restricted Eating to Treat Obesity

Poster Number: 617
Publication Number: 617.2777

Background: Over 40% of adults and more than 25% of children in the U.S. have obesity. Obesity's heritability ranges from 40-75%, making family-based treatments crucial. Standard of care (SOC) family-based obesity treatment achieves negative energy balance through changing the energy density and amount of food consumed; increasing physical activity; and strategic parenting practices. However, these interventions are resource- and time-intensive. Time-restricted eating (TRE), which limits the eating window while allowing ad libitum intake, could be a more manageable and resource-efficient approach for families. While TRE has been shown to reduce BMI in adults, its effectiveness in family settings remains untested.

Objective: Evaluate feasibility, acceptability, and efficacy of TRE compared to SOC in families with obesity, characterized by parent-child dyads of children aged 3-9 years, both having obesity (i.e., child BMI =/> 95th percentile; parent BMI =/>30 kg/m2).

Design/Methods: Randomized pilot study comparing 12 weeks of TRE (family eating window was to stop eating after evening meal) to SOC (changes to food energy density and portions) in dyads. Dietary sessions occurred weekly for the first month and every other week afterwards. Outcomes (e.g., anthropometrics, satisfaction, 24-hour recall) were measured at baseline and 12-weeks. Child and adult outcomes (change from baseline) were compared between arms using two-sample t-tests. Family outcomes used linear mixed models accounting for clustering within family.

Results: Eighteen families enrolled (TRE=10; SOC=8), with 94% retention at week 12, supporting feasibility. Mean age was 39- and 7-years for adults and children, respectively (Table 1). TRE required less dietician time than SOC [84.3(18.0) vs 140.9(22.7) minutes; p<.0001]. Satisfaction for TRE and SOC was high, with 89% (TRE) and 100% (SOC) of families recommending their assigned intervention. There was not a significant difference in change in child BMI percentage of the 95th percentile between TRE and SOC (p=0.92; Table 2). SOC reduced parental BMI more than TRE (p=0.002). TRE reduced the eating window by -0.7(1.0) hours in children and -2.3(2.7) hours in adults.

Conclusion(s): TRE and SOC were feasible and acceptable family-based treatments for obesity in families of 3- to 9-year-olds. The version of TRE implemented in this study, not eating after the evening meal, did not improve outcomes compared to SOC. Prior studies show shorter eating windows are associated with greater BMI reduction. Individualized eating windows for each family member may improve efficacy of family-based TRE.