Design: Pragmatic randomised comparative-effectiveness trial (TEAM UP)
Population: 730 children aged 6 to 15 with obesity in 41 US primary care practices
Primary outcome: Change in percent of median BMI at 12 months
Effect: −6.4 vs −2.6; difference −3.8 (95% CI −6.20 to −1.34)

TEAM UP randomised children with obesity to enhanced standard care led by their primary care clinician, or to the same care plus family-based behavioural treatment with a trained interventionist. Each child took part with a parent, and treatment lasted 12 months.

Family-based treatment produced a larger reduction in relative weight, and weight-related quality of life improved more. Blinded assessors measured outcomes.

The absolute difference is modest but meaningful in children, and the trial reached a socioeconomically diverse population. In India, where structured paediatric weight services are scarce, the model suggests training a non-physician worker to deliver family sessions alongside clinic visits.

Percent median BMI fell 6.4 points with family-based treatment against 2.6 with enhanced care alone.
Sessions covered eating, activity, positive parenting and managing home cues.
Quality of life improved in both groups, more with family treatment.
Nearly half the children had public insurance and one in five had food insecurity.
No trial-related adverse events were reported.

Why it matters

Family-based treatment has mostly been delivered in specialist centres; this shows it works when embedded in ordinary primary care.

The statistics, in plain English

Percent of median BMI compares a child's BMI with the median for age and sex, so it tracks change as children grow. A difference of 3.8 points with an interval from 1.3 to 6.2 is unlikely to be chance.