FOR HEALTH: A Family-oriented Healthy Eating, Activity and Lifestyle Intervention for Obese Preschool Children and Their Families.

• Change in Quality of Life Scores (PedsQL 4.0) [ Time Frame: Baseline, 3, 6, 9, 12 months ] [ Designated as safety issue: No ]
  Instrument used: PedsQL 4.0 Generic Core Scales, parent report, for toddlers (age 2-4), or for young children (age 5-6).
• Change in physical activity score (Netherlands Physical Activity Questionnaire for Young Children, NPAQ) [ Time Frame: Baseline, 3, 6, 9, 12 months ] [ Designated as safety issue: No ]
• Change in parent-reported daily screen-time (TV, computer) [ Time Frame: Baseline, 3, 6, 9, 12 months ] [ Designated as safety issue: No ]
  Parent-reported daily screen-time, estimated to the nearest 15 minutes.
• Change in fruit & vegetable consumption assessed by 3-day food records [ Time Frame: Baseline, 3, 6, 9, 12 months ] [ Designated as safety issue: No ]
• Change in dairy-product consumption assessed by 3-day food records [ Time Frame: Baseline, 3, 6, 9, 12 months ] [ Designated as safety issue: No ]
• Change in grain-product consumption assessed by 3-day food records [ Time Frame: Baseline, 3, 6, 9, 12 months ] [ Designated as safety issue: No ]
• Change in consumption of sugar-sweetened beverages assessed by 3-day food records [ Time Frame: Baseline, 3, 6, 9, 12 months ] [ Designated as safety issue: No ]
• Change in percent overBMI [ Time Frame: Baseline, 3, 6, 9, 12 months ] [ Designated as safety issue: No ]
  Percent overBMI is the percentage above the 50th percentile of BMI for the respective age and gender [(BMI-BMI at 50th percentile)]/BMI at 50th percentile]*100

The aim of this study is to investigate whether a community-based 6-month intervention for obese preschool children 2-5 years of age and their families, referred by their family physician, will be successful in preventing further increase in the participants' degree of obesity.

Participating children will be randomized to either receive a multidisciplinary lifestyle intervention during the first 6 months, treatment arm, or 6 months later, control or wait list arm. Within each arm participants will further be randomized to either a standard intervention group, or to an extended intervention group, which will receive an additional free 6-month YMCA membership.

• Active Comparator: Secondary lifestyle intervention arm
  6-month wait list group. Second arm to receive multidisciplinary, family-centered lifestyle intervention with behavioral counseling, following of completion of main 6-month intervention for arm 1.
  Intervention: Behavioral: Multidisciplinary, family-centered lifestyle intervention with behavioral counseling
• Experimental: Primary lifestyle intervention arm
  First arm to receive multidisciplinary, family-centered lifestyle intervention with behavioral counseling
  Intervention: Behavioral: Multidisciplinary, family-centered lifestyle intervention with behavioral counseling

Inclusion Criteria:

• Children aged 2-5 on study entry with primary obesity, BMI > 97th percentile for age and sex on 2010 WHO Growth Charts for Canada
• Family meets Readiness for change criteria, contemplation or higher stage, according to Prochaskas Transtheoretical Model.
• At least one parent/caregiver committed to attend all the program sessions with the child
• Parent/caregiver is agreeing to complete the study questionnaires at the required time points

Exclusion Criteria:

• Chronic medical conditions potentially impacting program participation or associated with a potentially increased risk in participation (e.g. type 1 diabetes mellitus, heart-, gastrointestinal-, or kidney diseases, uncontrolled asthma, other physical, developmental or psychological disabilities that could limit extent of study participation
• Regular use of medications that could limit extent of study participation
• Other concurrent or recently (last 12 months)received obesity treatment
• Inability to read, speak, and/or verbally understand English
• Living outside of the greater London, Ontario, area