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Pediatr Obes. 2015 Aug;10(4):275-82. doi: 10.1111/ijpo.261. Epub 2014 Sep 18.

Adolescents with severe obesity: outcomes of participation in an intensive obesity management programme.

Author information

1
Department of Paediatrics, University of Toronto, Toronto, ON, Canada.
2
Division of Endocrinology, The Hospital for Sick Children, Toronto, ON, Canada.
3
Department of Psychology, The Hospital for Sick Children, Toronto, ON, Canada.
4
Division of Paediatric Medicine, The Hospital for Sick Children, Toronto, ON, Canada.
5
Division of Cardiology, The Hospital for Sick Children, Toronto, ON, Canada.

Abstract

BACKGROUND:

Most interventions for childhood obesity are randomized controlled studies. Less is known about the effectiveness of clinical obesity programmes.

OBJECTIVE:

To assess outcomes in adolescents participating in the SickKids Team Obesity Management Program (STOMP) vs. a comparison group of obese adolescents.

METHODS:

Severely obese adolescents (n = 75) in STOMP (15.1 ± 1.8 years, body mass index [BMI] 44.8 ± 7.8 kg m(-2) ) were compared with adolescents (n = 41) not in the programme (14.9 ± 2.0 years, BMI 34.5 ± 8.0 kg m(-2) ). Outcomes were change in BMI, cardiometabolic, psychological and health behaviour measures.

RESULTS:

At 6 months, STOMP patients' BMI was unchanged (0.08 ± 0.3; P = 0.79) and they reported improvements in quality of life and depression (-3.6 ± 1.4; P = 0.009), and increases in measures of readiness to change (RTC). Between-group differences in change between 0 and 6 months, in favour of STOMP patients, were observed for homeostatic measurement assessment-insulin resistance (HOMA-IR; -2.7 ± 1.0; P = 0.007), depression scores (-3.5 ± 1.7; P = 0.04), diet-RTC (0.6 ± 0.2; P < 0.001) and physical activity (1.7 ± 0.9; P = 0.05). At 12 months, STOMP patients increased BMI (0.8 ± 0.5; P = 0.07), but they exhibited decreased waist circumference (-7.4 ± 2.1 cm; P = 0.001) and HOMA-IR (-1.9 ± 0.6; P = 0.002). Between-group differences in change between 0 and 12 months, in favour of STOMP patients, were observed for waist circumference (-5.9 ± 2.4 cm; P = 0.01), HOMA-IR (-2.9 ± 0.7; P < 0.001) and diet-RTC (0.9 ± 0.2; P < 0.001).

CONCLUSIONS:

STOMP participants did not experience a significant reduction in BMI but did have improvements in cardiometabolic, psychological and health behaviour outcomes. Evaluation of paediatric clinical obesity programmes using multiple measures is essential to understanding real-world outcomes.

KEYWORDS:

Adolescent obesity; clinical obesity programmes; outcomes; programme evaluation

PMID:
25236943
DOI:
10.1111/ijpo.261
[Indexed for MEDLINE]

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