Abstract
BackgroundMultidisciplinary group therapies for obese children and adolescents are effective but difficult to implement. There is a crucial need to evaluate simpler management programs that target the obese child and his family. This study aimed to determine changes in body mass indexes (BMI) after individual family-based obesity intervention with a pediatrician in a specialized obesity center for child and adolescent.MethodsThis cohort study included 283 patients (3.3 to 17.1 years, mean 10.7 ± 2.9) attending the Pediatric Obesity Care Program of the Geneva University Hospitals. Medical history and development of anthropometric were assessed in consultations. Pediatricians used an integrative approach that included cognitive behavioral techniques (psycho-education, behavioral awareness, behavioral changes by small objectives and stimulus control) and motivational interviewing. Forty five children were also addressed to a psychologist.ResultsMean follow-up duration was 11.4 ± 9.8 months. The decrease in BMI z-score (mean: -0.18 ± 0.40; p < .001) was significant for 49.5% of them. It was dependant of age, BMI at baseline (better in youngest and higher BMI) and the total number of visits (p = .025). Additional psychological intervention was associated with reduced BMI z-score in children aged 8 to 11 years (p = .048).ConclusionsIndividual family obesity intervention induces a significant weight reduction in half of the children and adolescents, especially in the youngest and severely obese. This study emphasizes the need to encourage trained pediatricians to provide individual follow up to these children and their family. Our study also confirms the beneficial effect of a psychological intervention in selected cases.
Highlights
Multidisciplinary group therapies for obese children and adolescents are effective but difficult to implement
We excluded children or adolescents if: 1) body mass indexes (BMI) z-score was normal, i.e.
Visits All subjects visiting the center for the first time were attributed, according to their age, to a pediatrician trained in motivational interviewing and obesity care, assisted by a nurse trained in behavioral techniques
Summary
Multidisciplinary group therapies for obese children and adolescents are effective but difficult to implement. There is a crucial need to evaluate simpler management programs that target the obese child and his family. This study aimed to determine changes in body mass indexes (BMI) after individual family-based obesity intervention with a pediatrician in a specialized obesity center for child and adolescent. About 20% Swiss children and adolescents are considered overweight and 5 to 8% of them are obese [1]. The most recent Cochrane review evaluated sixty-four randomized controlled trials in community setting of educational, behavioral and health promotion interventions for childhood obesity [2]. Authors concluded that comprehensive strategies involving the whole family to the purpose of this project was to investigate changes in body mass index (BMI) in obese children and adolescents attending a specialized obesity care center in individual setting
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