A programme tailored for obese kids has yielded some promising results, with children reporting better physical and emotional health after just a year.
Offered only in Taranaki and still running, the Whanau Pakari programme was designed to take healthcare out of hospitals and into people's homes and communities.
Researchers at the University of Auckland's Liggins Institute tracked just over 200 children aged 5 to 16 who entered the programme for 12 months.
"It was evident the best way to address weight issues in young people was to de-medicalise what is a very personal condition, and design a new kind of service that removes the stigma and judgment around obesity," said Dr Yvonne Anderson, a Liggins Institute researcher and paediatrician at Taranaki District Health Board.
"While Whanau Pakari may not be a silver bullet, many participants that engage and stick with the programme do really well."
In the clinical trial, which was embedded into the wider programme, the kids were split into two groups - designated "high intensity" and "low intensity".
All received a home visit involving a comprehensive health assessment and personalised advice at the beginning, and at six- and 12-month time points.
Those in the high-intensity group were also invited to weekly group sessions at community venues on topics including cooking, virtual supermarket tours, sports and physical activity, and making persistent lifestyle changes, Anderson said.
Among the findings of the study, published today in the international journal Obesity, were consistent improvements in cardiovascular fitness in both groups.
The high-intensity group, particularly, were on average half a minute, or 11 per cent, faster on a 550m walk and run test.
There were also big gains in quality of life in both groups - and the change in the high-intensity group shifted them to within the range of peers who do not have weight issues.
Other results included modest reductions in adjusted body mass index (BMI).
The one-fifth of participants who attended more than 70 per cent of weekly sessions in the high-intensity group had double the reduction in adjusted BMI, which moved some out of the "obese" BMI range into the "overweight" or "normal weight" ranges.
"The kids and teens are, overall, emotionally healthier and happier - which is not always an outcome of these types of obesity interventions," Anderson said.
"The improvement in quality of life was clinically meaningful - which means the effect of the intervention is likely to have a positive health benefit for the individual long-term."
Almost three in 10 of the children in the study came from households in the most deprived neighbourhoods of Taranaki.
Maori made up just under half of more than 650 children referred so far.
Many serious weight-related issues, such as obstructive sleep apnoea, were picked up for the first time and addressed.
New Plymouth 9-year-old Malachi Olliver-Te Huia was 8 when he was referred to the programme last year, and finished up with a better BMI score.
Previously, he came home from school most days to play games on his tablet or watch movies.
But once he and his grandparents, Larry and Faye, realised how much screen time affects his health, he managed to almost halve it.
Now, Malachi was just as likely to play after-school sport or take his rabbit for a walk.
The family have replaced fizzy drink with water as their everyday drink, and reserve fizzy and lollies for special occasions.
"I'm playing more sports, and I feel better too," Malachi said.
"No more sugar rushes. I feel good, healthy. I'll probably stick with it - my Nan said I will."
Another participant, Rangiwhaiao Hepi-Puke, was now much fitter after joining the programme five years ago.
The Hawera 15-year-old was active most days and easily reached 12,000 steps each day.
"These findings are really important," Anderson said.
"If we are going to make a difference to those most affected by obesity, services that families feel comfortable with, and that fit in with their lives, are key."
The findings follow a series of studies on baseline data that provided snapshots of different aspects of the children's health and wellbeing when they entered the programme.
"We have, as a research group, been highlighting the challenges tamariki and whanau face with obesity," Anderson said.
New Zealand has the third highest obesity rate in the OECD - 30.7 per cent of the population - after the United States and Mexico.
About 11 per cent of New Zealand children aged 2 to 14 years have obesity - an estimated 85,000 children) - and children living in most deprived neighbourhoods were five times more likely to experience obesity than those from the least deprived areas.
"We want to keep improving the intensive model so that it inspires families and whanau from all backgrounds to persist with the programme, given our findings show attendance is key to success," Anderson said.
The Whanau Pakari programme is a collaboration between the Taranaki District Health Board and Sport Taranaki.