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Arch Pediatr Adolesc Med. 2012 Dec;166(12):1103-8. doi: 10.1001/2013.jamapediatrics.319.

Response of severely obese children and adolescents to behavioral treatment.

Author information

1
National Childhood Obesity Center, Department of Pediatrics, Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden. pernilla.danielsson@karolinska.se

Abstract

OBJECTIVES:

To investigate whether the degree of obesity predicts the efficacy of long-term behavioral treatment and to explore any interaction with age.

DESIGN:

A 3-year longitudinal observational study. Obese children were divided into 3 age groups (6-9, 10-13, and 14-16 years) and also into 2 groups (moderately obese, with a body mass index [BMI]-standard deviation [SD] score [or z score] of 1.6 to <3.5, and severely obese, with a BMI-SD score of ≥3.5).

SETTING:

National Childhood Obesity Center, Stockholm, Sweden.

PARTICIPANTS:

Children 6 to 16 years of age who started treatment between 1998 and 2006.

INTERVENTION:

Behavioral treatment of obesity.

MAIN OUTCOME MEASURE:

Change in BMI-SD score during 3 years of treatment; a reduction in BMI-SD score of 0.5 units or more was defined as clinically significant.

RESULTS:

A total of 643 children (49% female children) met the inclusion criteria. Among the youngest moderately obese children, 44% had a clinically significant reduction in BMI-SD score (mean reduction, -0.4 [95% CI, -0.55 to -0.32]). Treatment was less effective for the older moderately obese children. Twenty percent of children who were 10 to 13 years of age and 8% of children who were 14 to 16 years of age had a reduction in BMI-SD score of 0.5 units or more; 58% of the severely obese young children showed a clinically significant reduction in BMI-SD score (mean reduction, -0.7 [95% CI, -0.80 to -0.54]). The severely obese adolescents showed no change in mean BMI-SD score after 3 years, and 2% experienced clinically significant weight loss. Age was found to be a predictor of a reduction in BMI-SD score (odds ratio, 0.68 units per year [95% CI, 0.60-0.77 units per year]).

CONCLUSIONS:

Behavioral treatment was successful for severely obese children but had almost no effect on severely obese adolescents.

Comment in

PMID:
23108856
DOI:
10.1001/2013.jamapediatrics.319
[Indexed for MEDLINE]
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