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ISRN Obesity  2012 

Determinants of Weight Loss in an Interdisciplinary Long-Term Care Program for Childhood Obesity

DOI: 10.5402/2012/349384

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Abstract:

Background. Efforts are needed to improve the long-term efficiency of childhood obesity treatment. To adapt strategies, the identification of subgroups of patients with a greater weight loss may be useful. Objective. To analyze the results of a chronic care program for childhood obesity and to determine baseline factors (medical, dietary, and psychosocial) associated with successful weight loss. Subjects and Method. We set up a family-targeted and individually adapted interdisciplinary long-term care program. We reviewed the medical files of 144 children (59 boys and 85 girls; ?y; mean BMI-z-score: ) who had ≥2 interdisciplinary visits and ≥1-year treatment. Results. Mean treatment length was 2.2?y (1–6.7?y) with visits/year. The duration of treatment did not depend on the initial weight loss, but this was predictive of the weight change over time. Furthermore any additional weight loss was observed with time whatever the initial weight change. High levels of physical activity and daily water intake from baseline conditions were associated with a greater weight loss after 9 months of intervention. In contrast, a high baseline consumption of soft drinks resulted in lower weight loss. Family specific factors such as being a single child or the child’s family support were identified as baseline factors which may contribute to better results. Conclusion. Our study suggests that the benefit of a chronic weight control program supports the need for its integration into the current concept of treatment. Better prevention policy and parental support may improve the success of the childhood obesity treatment. 1. Introduction Childhood obesity has spread dramatically over the previous decades. To curtail this major health issue, long-term effective weight control programs are essential. In the short term, several studies have shown positive and encouraging outcomes of multidisciplinary approach for childhood obesity. A combination of dietary, physical activity and behavioural interventions compared to standard care or self-help can produce a significant and clinically meaningful reduction in obesity in children and adolescents [1, 2]. This highlights the importance of multidisciplinary programs as the best first-line treatment. However, in most studies, programs are limited to between 6 and 12 months of duration, and beneficial effects are partly lost from 6 to 12 months after completion [3], especially for severely obese children [4]. Long-term follow-up studies of paediatric obesity interventions show a mean 10% reduction in relative weight but also substantial

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