Devdutta Sangvai, MD, MBA President, Duke Regional Hospital and Vice President for Population Health Management, DUHS | Duke University Hospital
Devdutta Sangvai, MD, MBA President, Duke Regional Hospital and Vice President for Population Health Management, DUHS | Duke University Hospital
Referrals by pediatric primary care providers to a community-led lifestyle program have shown positive results in improving the health of children with obesity, according to research led by Duke Health. The study, published on February 10 in Pediatrics, involved 255 children aged 5-17. Those who participated in the six-month Fit Together program saw significant improvements in body mass index and overall health markers. The program was organized by Durham Parks and Recreation and included six hours of weekly classes focused on physical activity and nutrition.
Researchers highlighted that this approach addresses a healthcare delivery issue by providing clinicians with a way to prescribe accessible lifestyle interventions for families. "Clinicians have a brief amount of time to make an impact during an annual visit and simply telling people to eat healthier or providing superficial counseling doesn't work," said Sarah Armstrong, M.D., corresponding author of the study and professor at Duke University School of Medicine.
Armstrong noted that intensive lifestyle treatment programs can be effective but are often hard to find or expensive. A municipal program offering these services makes recommendations more accessible, actionable, and meaningful for families.
While all participants showed improvements compared to the control group, there were no significant changes in cardiovascular fitness between groups. The COVID-19 pandemic posed limitations; however, children without COVID-related interruptions experienced the highest improvement.
"Municipal partners provide valuable resources to the communities they serve," said Cody Neshteruk, Ph.D., assistant professor at Duke University School of Medicine. By partnering clinics with communities, both can contribute knowledge and resources for better resident health.
The study also emphasized the benefit of receiving intensive lifestyle support alongside peers with similar diagnoses, which may enhance engagement. Armstrong mentioned that while programs like Fit Together are impactful tools, they should complement existing weight loss therapies such as GLP1 medication.
Efforts are underway to launch similar programs nationwide in collaboration with various municipalities. An online version has been launched with Durham Parks and Recreation.
The research team included Jennifer S. Li, William E. Kraus, Svati Shah, Mary Story, Nancy Zucker, Jason Jones, Eliana M. Perrin, Alexandra R. Zizzi, Joshua Burrows, Brooke E. Wagner, McAllister Windom, Tracy Truong Hwanhee Hong and Asheley C Skinner.
Funding was provided by the American Heart Association (17SFRN33670990), National Institutes of Health (R24-DK110492), and Duke Endowment.
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