by Sara N. Reardon

When it comes to weight loss, it seems that no one is an island, especially children. At the West Seattle YMCA, a program called Actively Changing Together! (ACT!), formerly known as Strong Kids/Strong Teens, is teaching families with overweight children and parents about healthy lifestyles by encouraging them to work together toward their weight-loss goals.

“We’re about helping parents and kids have better communication, creating an environment where fun experiences happen in healthy lifestyles,” said YMCA disease prevention director Lindsey Gregerson, who heads the program. During the 12-week course, families run relay races and obstacle courses together and discuss their food choices with a nutritionist. At the end of the class, the families cook a light meal to share. The goal, says Gregerson, is to “keep everything fun.”

With nearly one-third of American children overweight or obese, the causes behind what has been described as an “epidemic” of child obesity have become a prime question for research. First lady Michelle Obama’s “Let’s Move!” campaign largely targets grade schools, encouraging them to offer more wholesome food options and physical education. And it’s long been known that children with overweight parents are more likely to become overweight themselves.

Yet researchers are finding that reversing this trend may ultimately lie with an even larger group of influences: the neighborhoods that children call home.

“We know obesity can run in families; parents and kids are exposed to the same environment,” said pediatrician Dr. Mollie Grow, who helps lead the ACT! program. Environmental factors such as the availability of parks, access to safe play areas for children, walking distance to stores and other destinations, and number of healthy food options likely have an effect – and all tend to be more difficult to come by in disadvantaged areas.

In 2007, UW researcher Dr. Adam Drewnowski made headlines with the finding that high levels of obesity tightly associate with zip codes with low-median property value in King County. Grow collaborated with Drewnoski and other researchers for a new study, which took it one step further: studying the effects on children.

Using anonymous electronic medical records from Group Health patients, Grow’s group compared children’s height and weight with census tract information, an even more precise measure than zip code. They found that socioeconomic factors such as mothers’ average education levels, number of single-parent households, median household income, and racial makeup within a census tract strongly predict how likely its children are to be overweight.

Grow’s study is unique in that it looks at small sections of a population, which allows her to use very robust statistical tests to find a correlation between neighborhoods and obesity. While obesity levels in Washington are lower than in much of the country, the findings mirror trends seen in numerous areas around the world. "What we found confirms that it takes a village to raise a child," Grow said in a press release.

The next step is to determine the specific causes for the correlation – and how to fix them. “We look at the health disparities that exist – and they do exist – and we ask why is that,” said Dr. Brian Saelens of Seattle Children's Hospital, who was a coauthor on the study.

Like Grow, Saelens is proactive in providing solutions for the problem he studies. His program, COMPASS, is funded by the National Institutes of Health and studies how to best influence families to make lasting lifestyle choices. Families with overweight children and at least one overweight parent can participate in the yearlong weight-loss program, which includes recreation activities, nutrition education and personal goal setting.

Unlike most weight-loss programs and studies, the COMPASS program lasts for a whole year, which Saelens believes might help permanently establish good habits. COMPASS monitors their progress with follow-up studies and surveys that families fill out. “We’re the only program offering this long family-based treatment,” said Saelens. In return for their participation, the families receive free obesity treatment and health education, something not covered by insurance plans.

The ACT! program also hopes to overcome the obesity-income disparity by offering a tiered fee system for their services, which is partially subsidized by donations. “We recognize that the statistics show an increased challenge for low-income families in living a healthy lifestyle,” said Gregerson. Costs range from $165 at the highest tier to $45 at the lowest.

All agree that families do better in their weight-loss goals when they can work together. “People generally know what they should be doing,” said Gregerson, “but the support aspect is important to get a real behavioral change.”

The COMPASS study is currently recruiting; families interested in participating are encouraged to contact Gabrielle Ghafari (206-884-6312).

For more information on the YMCA’s ACT! program, contact Rebecca Gray at rgray@seattleymca.org.

SARA REARDON is a student in the University of Washington Department of Communication News Laboratory.