Extremely obese children respond better than extremely obese adolescents to lifestyle interventions. Issue 1 (17th December 2013)

• Record Type: Journal Article
• Authors: Knop, C.; Singer, V.; Uysal, Y.; Schaefer, A.; Wolters, B.; Reinehr, T.
• Is Part Of: Pediatric obesity. Volume 10:Issue 1(2015:Feb.)
• Page Start: 7
• Page End: 14
• Publication Date: 2013-12-17
• Subjects: Obesity in children -- Periodicals; Obesity in adolescence -- Periodicals; Obesity -- Periodicals; Overweight children -- Periodicals; 618.92398
• DOI: 10.1111/j.2047-6310.2013.00212.x
• Languages: English
• ISSNs: 1747-7174

Abstract

<abstract abstract-type="main"> <title>Summary</title> <sec id="ijpo212-sec-0001" sec-type="section"> <p> <list id="ijpo212-list-0001" list-type="bullet"> <title>What is already known about this subject</title> <list-item> <p>Lifestyle intervention is regarded as therapy of choice in obese children and adolescents.</p> </list-item> <list-item> <p>It is unclear whether extremely obese children and adolescents respond to lifestyle intervention.</p> </list-item> </list> </p> </sec> <sec id="ijpo212-sec-0002" sec-type="section"> <p> <list id="ijpo212-list-0002" list-type="bullet"> <title>What this study adds</title> <list-item> <p>Extremely obese children respond better than obese children to a lifestyle intervention.</p> </list-item> <list-item> <p>In contrast, most extremely obese adolescents achieved no weight loss in lifestyle intervention suggesting that other treatment approaches are needed for them.</p> </list-item> </list> </p> </sec> <sec id="ijpo212-sec-0003" sec-type="section"> <title>Background</title> <p>There are conflicting results of treating extreme obesity in childhood by lifestyle interventions in the literature.</p> </sec> <sec id="ijpo212-sec-0004" sec-type="section"> <title>Methods</title> <p>We analysed the outcome of a 1‐year lifestyle intervention in an intention‐to‐treat approach in 1291 children (mean age 11.0 ± 2.5 years, mean body mass index [BMI] 27.5 ± 4.7 kg m<sup>−2</sup>, 55.8% female, 62.4% obese, 37.6% extremely obese (defined by BMI‐SDS >2.3) at end of intervention and 1 year later.</p> </sec> <sec id="ijpo212-sec-0005" sec-type="section"> <title>Results</title> <p>The mean BMI‐SDS reduction was −0.20 ± 0.32 at end of intervention and −0.14 ± 0.37 1 year after end of intervention compared to baseline (comparing intervention vs. 1 year later <italic>P</italic> = 0.010). Extremely obese children ≤10 years demonstrated a significantly greater BMI‐SDS reduction than obese children ≤10 years (−0.24 ± 0.38 vs. −0.16 ± 0.38, <italic>P</italic> = 0.021). Extremely obese adolescents >10 years demonstrated a significantly lower BMI‐SDS reduction compared to obese adolescents >10 years (−0.05 ± 0.30 vs. −0.15 ± 0.39, <italic>P</italic> < 0.001). Comparing the BMI‐SDS reduction between obese children <10 years and >10 years revealed no significant difference (<italic>P</italic> = 0.195) in contrast to the comparison between extremely obese children <10 years and >10 years (<italic>P</italic> < 0.001). The same findings were observed in the follow‐up period after the end of intervention.</p> </sec> <sec id="ijpo212-sec-0006" sec-type="section"> <title>Conclusions</title> <p>Our study demonstrated an encouraging effect of lifestyle intervention in extremely obese children ≤10 years at the end of intervention and 1 year later, but only a limited effect in extremely obese adolescents >10 years.</p> </sec> </abstract>