CDC-Recognized Family Healthy Weight Programs

Background

FHWPs are comprehensive, family-based lifestyle change programs. They help children with overweight or obesity make progress toward a healthier weight through positive behavior changes. FHWPs are safe, effective treatments that are designed for children and their families or caregivers. FHWPs are also known as intensive health behavior and lifestyle treatment programs.

Several national organizations, including the U.S. Preventive Services Task Force (USPSTF) and the American Psychological Association, recommend FHWPs to help treat childhood obesity. American Academy of Pediatrics (AAP) recommends that clinicians refer children ages 2 to 18 years with overweight or obesity to family-based programs with a minimum of 26 contact hours.

Benefits

In addition to reducing or stabilizing a child's weight or body mass index (BMI), some studies reported that FHWPs:

• Reduced parent or caregiver weight.
• Improved nutrition, physical activity, and associated behaviors.
• Improved health-related quality of life, including self-esteem.
• Improved metabolic markers, such as blood pressure and lipids.
• Improved parental stress, self-efficacy, and quality of life. Self-efficacy is the belief in one's ability to succeed at something.

CDC-recognized FHWPs

CDC-recognized FHWPs meet the screening criteria below. The programs are packaged to be ready-to-use and intended for rapid dissemination. They can be used in health care, community, or public health settings. This list of evidence-based programs is a resource for healthcare payers and systems, and clinical or community practitioners.

This list is not exhaustive. It will be updated periodically. For more information, please contact PHHT@cdc.gov.

Mind, Exercise, Nutrition...Do It! (MEND)

For families with children aged 2 to 13 years who have overweight or obesity.
MEND combines physical activity, healthy eating, and behavior change to encourage safe, effective weight management and lasting lifestyle changes. MEND is appropriate for many settings, including schools, recreation centers, and community-based organizations.

• MEND 6-13/Healthy Together is 60- to 120-minute sessions twice weekly for 10 weeks.
• MEND 2-5 is 90-minute sessions weekly for 10 weeks.

Healthy Weight and Your Child

For families with children aged 7 to 13 years who have obesity.
The curriculum for Healthy Weight and Your Child is adapted from MEND and implemented at participating YMCA locations. The program engages children and adults in nutrition education and physical activity to elicit positive change and to help families learn skills for healthier lifestyles. The program consists of 25 2-hour sessions delivered over 4 months.

Smart Moves for Kids/Bright Bodies

For families with children aged 7 to 18 years who have overweight or obesity.
Smart Moves combines nutrition education, behavior modification, physical activity, and parental/caregiver support. The goals are to nurture children's self-esteem and healthful behaviors while improving body mass index, body composition, and insulin resistance. The 12-week program includes two 45-minute exercise sessions and one 40-minute nutrition or behavior modification session weekly. This program was evidence-tested as Bright Bodies at Yale University.

Healthy Weight Clinic

For families with children aged 2 to 18 years who have overweight or obesity.
Healthy Weight Clinic is conducted in the primary care setting. It focuses on achieving positive behavior change, setting goals, managing obesity-related conditions, and linking families to community resources. Participants receive at least 30 contact hours over 12 months, including:

• Individual clinic visits (monthly)
• Group sessions (monthly for the first 6 months)
• Telephone check-ins (twice per month)
• Optional health messaging (twice per week).

Family-Based Behavioral Treatment (FBT)

For families with children and young adults aged 2 to 20 years who have overweight or obesity.
FBT emphasizes healthy eating, physical activity, and positive parenting. The goal is to empower families to practice new behaviors in a variety of settings to sustain healthy changes. FBT can occur in person or virtually, in a group setting, and through individual sessions with the child and parent or caregiver. FBT is delivered over at least 26 hours.

Building Healthy Families

For families with children aged 6 to 12 years who have obesity.
Building Healthy Families is tailored for people living in areas with less than 50,000 residents. Building Healthy Families works with families, especially children, to identify healthier food choices, modify unhealthy behaviors, and increase physical activity. The program consists of 2-hour weekly sessions (12 total) over 3 months, with 6 refresher sessions up to 1 year.

Program screening criteria

All CDC-Recognized FHWPs meet the screening criteria below.

Adequate evidence

Evidence for CDC-recognized family healthy weight programs is from a peer-reviewed study that was:

• Included in the evidence review for AAP's 2023 Clinical Practice Guideline for the Evaluation and Treatment of Children and Adolescents With Obesity, or
  
• Included in the evidence report for the 2017 USPSTF Recommendation Statement on Screening for Obesity in Children and Adolescents, or
• Identified from reviews of 2006 to 2022 Health and Human Services funding opportunities specific to childhood obesity and tested through one or more randomized control trials or comparative effectiveness trials.

Also, to meet CDC criteria, the evidence must have:

• Included primary study outcome(s) of at least one measure of weight or BMI, such as BMI, BMI z-score, or BMI percentile.
• Demonstrated improvements in at least one outcome of BMI or weight status in youth aged 2 to 18 years.

Appropriate for childhood obesity

CDC-recognized family healthy weight programs meet AAP's recommendation for dose and intensity to provide 26 or more contact hours over 3 to 12 months. The recognized programs also:

• Are intended for youth aged 2 to 18 years with:
  • Overweight (BMI at or above the 85^th percentile for sex and age) or
  • Obesity (BMI at or above the 95^th percentile for sex and age)
• Include behavioral intervention
• Are family-centered or use a family-based model
• Include both nutrition and physical activity counseling

Ready for Immediate Use

CDC-recognized family healthy weight programs:

• Are packaged for use in health care, community, or public health settings.
• Have a standard curriculum that is part of broader package of implementation materials.
• Have an online presence, such as a website or social media.
• Include publicly available contact information for questions, additional information, or technical assistance.
• Contain program materials available in English or Spanish.

Resources

Potential Activities
Activities that state and local organizations can do to assess gaps in access to family healthy weight programs, coordinate supports, and prepare for implementation of these programs.

Resources and Definitions
Tools for professional development and insurance plan reviews. Definitions of childhood obesity treatment, equitable implementation, and other key terms.

Healthcare Strategies
National guidelines, tools, and other resources for healthcare-related entities.