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Amanda Harrist, Oklahoma State University and Laura Hubbs-Tait, Oklahoma State University

(THE CONVERSATION) Hundreds of programs over the past four decades – from the removal of junk food from school vending machines to Michelle Obama’s “Let’s Move” campaign – have tried to get kids in the U.S. to eat healthier food and exercise more often.

But none of these efforts lowered national child obesity rates. In fact, child obesity has continued to increase. This has been particularly true during the pandemic.

We think we know why. Most programs that seek to lower children’s body mass index, or BMI, focus on healthy food and physical activity. But as child obesity researchers who specialize in human development and family science, we know that slimming down requires much more than attention to diet and exercise.

Those factors are important, but we found that acceptance from family and friends also plays a critical role in slowing the rate of weight gain for children with obesity.

To reach this conclusion, we collaborated with colleagues to follow almost 1,200 children in first through fourth grades in rural Oklahoma to find out more about the lives of kids who are overweight or obese. Our intervention programs allowed us to compare a traditional food and exercise approach to managing child obesity with approaches that also targeted the social and emotional aspects of children’s lives.

Family and peer acceptance

We conducted a randomized controlled trial in 29 Oklahoma schools. More than 500 first graders who were at-risk for obesity – meaning their BMI was above the 75th percentile – were assigned to either a control group or a group that received a combination of three interventions.

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