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Outpatient program equally effective in children with morbid obesity
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An ongoing, outpatient, tailored lifestyle intervention benefited children with overweight, obesity and morbid obesity, according to recent study findings published in The Journal of Clinical Endocrinology & Metabolism.
“At the Centre for Overweight Adolescents and Children’s Healthcare (COACH), an ongoing, outpatient, family-based, interdisciplinary care program has been developed, which is offered to children with overweight, obesity and morbid obesity,” the researchers wrote. “The COACH treatment is unique with regard to its long-term approach and the special attention that is given to the prevention of attrition during the treatment.”
Anita Vreugdenhil, MD, PhD, of Maastricht University Medical Center, Netherlands, and colleagues evaluated 172 children (73 boys; mean age, 11.9 years; baseline mean BMI z score, 3.45) participating in the COACH program to determine the effect of the intervention in children with morbid obesity compared with those with overweight and obesity.
The COACH program included a pre-intervention assessment and development of a tailored care program by a team and assignment of a case manager. Participants received the tailored care at the outpatient clinic. BMI z score was measured at 6, 12, 18 and 24 months.
Overall, 16% of participants had overweight, 40% had obesity and 44% had morbid obesity.
There was a sustainable decrease in BMI z score (P < .001) over time. During the first 12 months (P = .001) and the 12- to 24-month periods (P = .002), BMI z score decreased in the morbid obesity group. The changes in BMI z score were not significantly different between the groups. Twenty-one percent of participants with morbid obesity improved their weight status to the obese category after 12 months and 25% did so after 24 months. Six percent of participants with overweight improved to lean after 12 months and 15% did so after 24 months. Fifteen percent of participants with obesity improved to overweight after 12 months and 17% did so after 24 months.
After 12 months of intervention, serum total cholesterol (P = .044), LDL cholesterol (P = .006), HbA1c (P < .001), waist circumference z score (P = .035), diastolic blood pressure z score (P =.044) and pediatric nonalcoholic fatty liver index (P < .001) were reduced among the whole population.
“This intervention with high retention rates resulted in sustained improvement of BMI z score and cardiovascular risk parameters,” the researchers wrote. “This clearly illustrates that by offering a treatment that is continuous and prevents high attrition by engaging families with tailored care and activities it is possible to provide effective outpatient consultancy treatment even to children with morbid obesity. Results of this study therefore questions the need of expensive, stressful and invasive interventions, which may not be suitable for every child.” – by Amber Cox
Disclosure: The researchers report no relevant financial disclosures.
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