Effects of a combined intervention for treating severely obese prepubertal children.
ABSTRACT Abstract Introduction: Obesity has become the most common modern pediatric chronic disease. Early prevention and treatment of childhood and adolescent obesity is mandated. Severe obesity [body mass index (BMI) percentile >98%] reduces the likelihood of the multidisciplinary childhood obesity program to succeed, suggesting, most probably, that a more intense program is needed to treat severely obese children. Objective and methods: To prospectively examine the effects of an intense, 3-month, combined dietary-behavioral-physical activity intervention on anthropometric measures, leisure time activity patterns, and fitness in prepubertal severely obese (BMI percentile >98%) children (n=22) compared to age, gender, and obesity matched controls (n=18). Results: At 3 months, there were significant differences (p<0.05) in changes in body weight (-0.5±2.4 vs. 1.7±1.9 kg), BMI (-0.9±1.2 vs. 0.4±1.0 kg/m2), BMI percentile (0.39±0.39% vs. -0.04±0.32%), sum skinfolds (-3.1±8.1 vs. 1.1±4.7 mm), total habitual physical activity (25.4±10.8 vs. 0.3±10.1 Mets), and fitness (142±72 vs. -8±88 s) in the intervention vs. control participants. Conclusions: Our data demonstrate the beneficial, short-term effects of an intense combined dietary-behavioral-physical activity intervention on anthropometric measures, activity patterns, and fitness in severely obese children. However, despite the encouraging results, the modest effect on BMI percentiles emphasizes the difficulty of treating severely obese children using the conventional nutritional-behavioral-physical activity approach.
- [Show abstract] [Hide abstract]
ABSTRACT: Abstract We assessed the effect of a weight management program on body weight, body mass index (BMI), BMI percentile, and fitness in obese children and adolescents. The study was designed as a longitudinal, non-randomized, clinical experience of 3, 6, and 12 months combined dietary-behavioral-exercise intervention. Seven hundred and forty-nine obese children (age, 6-16 years) participated in a 3 months program. Three hundred and fifty-nine of them completed a 6 months intervention and 147 completed a 1 year intervention. Sixty-seven age- and maturity-matched obese children who did not participate in the structured program served as controls. Body weight, BMI, and fitness were evaluated at baseline, and after 3, 6, and 12 months intervention. Body weight, BMI, and BMI percentiles were significantly reduced (p<0.05) and endurance time significantly increased (p<0.0005) following the 3 months intervention. Obese children who continued the program for 6 months maintained decreases in BMI percentiles and further improved endurance time. In contrast, obese children in the control group gained weight, increased their BMI, and had a less significant improvement in fitness. Parental obesity (both parents), degree of obesity (BMI >97%), and more than one prior weight loss attempt were associated with lower decreases, whereas sex and pubertal status had no influence, on BMI percentiles changes. Children without parental overweight had significantly greater decreases in BMI compared with children with both parents showing obesity. In summary, a combined, structured multidisciplinary intervention for childhood obesity led to decreased body weight, BMI, and BMI percentiles, and to improved fitness.Journal of pediatric endocrinology & metabolism : JPEM. 01/2014;