Evidence-Based Programs → Family Healthy Weight Programs
Family Healthy Weight Programs
This page provides an introduction to family healthy weight programs (FHWPs), opportunities for reimbursement, and examples of FHWPs in practice.
- Introduction to Family Healthy Weight Programs
- Accessing Reimbursement Opportunities for Family Healthy Weight Programs
- Family Healthy Weight Programs in Practice
Introduction to Family Healthy Weight Programs
In response to growing obesity rates in children, there is an increased interest in supporting evidence-based, family-centered childhood obesity initiatives. These programs are critical given that they are tailored to the unique needs of children to increase healthy habits and decrease risks associated with obesity, including type 2 diabetes. FHWPs are unique in that they actively include family systems by involving parents and/or caregivers who play a central role in shaping children’s daily eating and activity habits. These programs also take into account the sensitivity about the topic of weight, while simultaneously supporting parents/caregivers with practical and tailored solutions.
As part of the Centers for Medicare and Medicaid Services (CMS) Quality Conference in July 2025, FHWPs were highlighted alongside the National Diabetes Prevention Program (National DPP) lifestyle change program and several other chronic disease prevention programs as evidence-based behavioral change interventions that share key tenants including improving physical activity and nutrition. The presentation highlighting the importance of these programs in the context of evidence-based chronic disease prevention can be viewed here (beginning at 09:14).
What is a Family Healthy Weight Program?
A FWHP is a comprehensive, family-based lifestyle change program aimed at helping children progress towards healthier weight through positive behavior change. FHWPs are supported and recommended by several national organizations including the U.S. Preventive Services Task Force (USPSTF), the American Psychological Association (APA), and the American Academy of Pediatrics (AAP) for children with overweight or obesity.
CDC-recognized FHWPs meet specific screening criteria for a safe and effective family-based lifestyle intervention including adequate evidence, appropriateness for childhood obesity, and readiness for immediate use. These programs are all designed for children and adolescents between the ages of 2-18 with a BMI above the 85th percentile. They are family-centered, involving parents or caregivers, and meet the required 26+ contact hours over the course of 3 -12 months. Programs are delivered as group or individual sessions, virtually or in-person, and can be delivered in community or clinical settings. All programs are delivered by staff that have received program-specific training. Examples of CDC-recognized FHWPs include Mind, Exercise, Nutrition…Do It! (MEND), Healthy Weight and Your Child, Smart Moves for Kids/Bright Bodies, Healthy Weight Clinic, Family-Based Behavioral Treatment (FBT), and Building Healthy Families. This list is not exhaustive, and additional information on CDC-recognized FHWPs and program screening criteria can be found on CDC’s FHWP page.
Evidence Supporting FHWPs
At a high-level, FHWPs help to reduce and stabilize a child’s weight and/or body mass index (BMI). Additional benefits for participants include improved lifestyle behaviors (e.g., nutrition and physical activity), increased self-esteem and self-efficacy, and improved metabolic markers (e.g., blood pressure and lipids). Reported benefits for parents and caregivers include reduced weight and stress, as well as improved self-efficacy and quality of life.
For additional detail on the evidence supporting FHWPs, please see the evidence review for AAP’s 2023 Clinical Practice Guideline for the Evaluation and Treatment of Children and Adolescents With Obesity, the evidence report for the 2017 USPSTF Recommendation Statement on Screening for Obesity in Children and Adolescents, and an article in the 2024 edition of Childhood Obesity, Moving Beyond Research to Public Health Practice: Spread and Scale of Interventions that Support Healthy Childhood Growth.
Implementation Tips for FHWPs
When implementing a FHWP, there are a variety of resources and frameworks that can guide the process. Helpful resources include the Exploration, Preparation, Implementation, Sustainment (EPIS) Framework, CDC’s Strategies for FHWPs page, and the National Association of Community Health Centers’ (NACHC) FHWP Implementation Guide. Each of these resources highlights the importance of thorough pre-implementation planning, intentional implementation processes, and ongoing evaluation.
Pre-implementation is an important time to gather information and learn from others who have implemented FHWPs. The pre-implementation phase is the time to identify community obesity-related needs and assets, develop and strengthen partnerships, and assess personnel and resource capacity. This information can help organizations choose the FHWP that is the best fit for the population they serve.
Once a specific FHWP is chosen, plans should be made regarding delivery approach, physical space or technology needs, accessibility, billing and sustainability, workflows, staff training, and participant recruitment. Collaboration and leaning on the strengths of trusted partners is critical to implementation of successful FHWPs. Organizations may consider adopting a pilot or phased approach to FHWP implementation to allow for built-in evaluation and quality improvement, as well as the ability to assess and adapt to unique participant needs along the way.
Accessing Reimbursement Opportunities for Family Healthy Weight Programs
Despite the evidence base for FHWPs, funding and reimbursement remain a challenge. Currently, FHWPs are most often funded through independent sponsors and grants, however, there are a few states who have accessed reimbursement through Medicaid.
Medicaid Coverage for FHWPs
While full Medicaid coverage for FHWPs is rare, there are pieces of FHWPs that can be reimbursed through Medicaid and commercial payers in many states. For example, some Childhood Obesity Management with MEND Implementation Teams (COMMIT!) sites integrated billable health care providers (e.g., physicians, physician assistants, nurse practitioners, registered dietitians) through a group centering model, as an extra layer to the FHWP. This allowed sites to obtain reimbursement when these health care providers were involved in the program. Some sites had billable visits up to once a week as part of the FHWP.
Generally, organizations must piece together various codes to obtain partial reimbursement—an effort that is often time-consuming and still falls short of covering the full program costs. Community-based organizations (CBOs) face additional barriers as they typically lack the billing infrastructure of clinical programs unless they partner with a clinical entity. Even when billable codes are available, organizations should proactively pursue external funding sources and alternative strategies to ensure long-term sustainability of their programs.
Making the Case for Coverage
When making the case for coverage for evidence-based programs, payers are generally interested in understanding return on investment (ROI). However, since FHWPs are focused on children, ROI is more challenging to calculate. This is largely due to the longer time horizon before a child would be diagnosed with type 2 diabetes that makes immediate savings to the payer more difficult to track and prove. When communicating with payers, it’s important to recognize the nuances of ROI for FHWPs, while emphasizing the evidence base for FWHPs.
As of March 2025, 37.3 million children were enrolled in either Medicaid or the Children’s Health Insurance Programs (CHIP), indicating the need to make the case for coverage for FWHPs within these programs.
State Examples of Coverage
Missouri
As of September 2021, Missouri Medicaid covers biopsychosocial treatment of obesity for youth and adults. Programs included under this treatment category integrate nutrition therapy and behavioral health counseling to facilitate behavior change. The FHWP developed by Washington University School of Medicine in St. Louis, FBT, provides training for behavioral health providers and registered dietitians that satisfies the state specialist certification requirement to become a provider under Missouri’s Medicaid benefit for biopsychosocial treatment of obesity. This Medicaid benefit allows FHWPs with certified state specialist providers to receive reimbursement for providing the program.
Family Healthy Weight Programs in Practice
Considerations for Working with Children
FHWPs are intentionally designed to involve parents or other adult caregivers to maximize meaningful changes to the family system around physical activity and nutrition. FHWPs provide a supportive environment for both parents and children to have fun and adopt healthier habits. FHWP staff are trained on how to talk to children and parents about weight in a non-stigmatizing way that promotes the mental well-being of all participants.
Intersection with Community Care Hubs
Payers are often interested in having a menu of evidence-based programs—such as the National DPP lifestyle change program, Diabetes Self-Management Education and Support (DSMES), and FHWPs—under a single roof, rather than having separate vendors for each program. When considering how to implement and sustain a FHWP, organizations may consider incorporating FHWPs into a community care hub (CCH). A CCH is a community-focused entity that organizes and supports a network of CBOs providing evidence-based chronic disease prevention and management programs and services to address health-related social needs (HRSN). CCHs can reduce the administrative burden on CBOs and allow them to focus instead on program delivery. To learn more about CCHs within the context of evidence-based programs, see the Community Care Hubs page of the Coverage Toolkit.
FHWP Examples
FHWPs can be implemented and operationalized in a variety of ways. The following examples show how FHWPs can be implemented by various organization types including Federally Qualified Health Centers (FQHCs), health systems, health departments, and CBOs.
COMMIT!
FHWPs in a Health System
The National Association of Community Health Centers (NACHC) partnered with CDC to create COMMIT! which promotes the adoption of FHWPs for FQHCs. COMMIT! has supported multiple FQHCs across Arizona, Colorado, Florida, and Mississippi to implement FHWPs. These efforts aim to identify critical components of successful program delivery and inform the development of scalable implementation guidance to expand FHWPs in underserved populations. NACHC created a FHWP Implementation Guide that outlines seven steps for successful implementation of a FHWP:
- Assess personnel and resource capacity
- Select curriculum and delivery approach
- Determine billing and sustainability
- Plan space and technology
- Configure workflow
- Recruit participants
- Evaluate and reflect
Several COMMIT! sites integrated billable health care providers (e.g., physicians, physician assistants, nurse practitioners, registered dietitians) through a group centering model, as an extra layer to the FHWP. This allowed sites to obtain reimbursement when these health care providers were involved in the program. Some sites had billable visits up to once a week as part of the FHWP.
Denver Health
FHWPs in a Health System
Denver Health is a safety-net health care system that serves underserved populations in Denver, including a network of nine FQHCs. In 2015, Denver Health began integrating MEND into its primary care clinics to reduce barriers to participation and increase engagement among Denver Health patients. The program was popular among families and Denver Health expanded MEND to four of its FQHCs. Additional information on Denver Health’s implementation of MEND is available here.
Health Department Capacity Assessment
FHWPs in Local Health Departments
The National Association of County Health Officials (NACCHO) worked to identify local health departments’ capacity to implement lifestyle management programs, such as FHWPs, to prevent and reduce excess weight in children. NACCHO found that one in three local health departments offer services related to weight management and/or children including nutrition education, physical activity, BMI screening, and school-based clinics. While local health departments are making meaningful efforts in this space, funding and staffing remain major barriers to healthy weight programming. Data and program evaluation findings on FHWPs are necessary to obtain and sustain funding. NACCHO’s full study findings and infographic are available here.
YMCA of Metropolitan Milwaukee
FHWPs in a CBO
YMCA of Metropolitan Milwaukee utilizes the Healthy Weight and Your Child program to empower children and families to address childhood obesity. Program staff include an information session prior to starting the 25 2-hour sessions that occur over the course of four months. Each session includes activities for both the child and their caregiver. Additional information on YMCA of Metropolitan Milwaukee’s Healthy Weight and Your Child program is available here.
YMCAs can offer programs at branch locations or after school sites. They can also consider providing participants and their families with access to YMCA memberships and other programs that support healthy lifestyle changes.
