Childhood Obesity: Concept, Feasibility, and Interim Results of a Local Group-based, Long-term Treatment Program
Abstract
Objective
The authors performed a group-based program for obese children and adolescents in Bavaria, Germany to enable them to establish a health-oriented lifestyle and to reduce overweight. The authors compared this program with a control approach based on the patients' own initiative.
Design
This is a controlled clinical trial.
Setting
A nutrition program for outpatients in a German university hospital.
Participants
Seventy-three obese patients aged 7 to 15 years (mean 11.2 years) were recruited by pediatricians and local newspaper reports and randomized into intervention and control groups. Children and adolescents in each group were divided into 3 groups according to age–7-8 years, 9-10 years, and 11-13 years. Children were classified overweight (defined as body mass index (BMI) > 90th percentile for age and gender), obese (BMI > 97th percentile), and extremely obese (BMI > 99.5th percentile), according to the European Childhood Obesity Group and the German Working Group on Pediatric Obesity, congruent with adult standards used to assess overweight and obesity.
Intervention
Thirty-seven patients (age 7-13 years, mean 10.9 years) for the 1-year intervention. This intervention consisted of modules for physical activity, nutritional education, and coping strategies. The program was performed twice each week and incorporated parental participation and medical supervision, including laboratory tests. The obese controls (n = 36, age 8-15 years, mean 11.6 years) received written therapeutic advice during a visit at 0 and 6 months in the outpatient clinic.
Main Outcome Measure
The primary outcome variable was the body mass index (BMI) z score.
Analysis
Analysis of variance and t test were used, and a P value < .05 was considered significant.
Results
There was a reduction of BMI z score in the active treatment group (P < .05), but not for controls. Moreover, the active group showed beneficial effects for body mass index (BMI), fat mass, and systolic blood pressure 12 months after beginning the intervention.
Conclusions and Implications
Group-based programs for young, obese patients can be effective tools for establishing a health-oriented lifestyle and reducing the burden of obesity.
3Public Health Authority, Erlangen-Hoechstadt, Germany
Address for correspondence: Ina Knerr, MD, PhD, Children's and Adolescents' Hospital, University of Erlangen-Nuremberg, Loschgestr. 15, D-91054 Erlangen, Germany; Phone: +49 9131 85-33118; Fax: +49 9131 85-33113
This project was funded by the Bavarian State Ministry of Environment, Public Health, and Consumer Protection and the health insurance company SBK, Germany.
ABSTRACT