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Long-term management of obesity in paediatric office practice: experimental evaluation of two different types of intervention


  • * Other participants include: A. Bettinardi, A. Biolchini, P. Bovolato, L. Brivio, R. Cazzaniga, A. Corbetta, L. Crespi, G. Fasani, C. Gussoni, G. Lietti, M. Limonta, G. Meregalli, M. Narducci, L. Scotti, B. Vignati, F. Zanetto.

Elisabetta Sala, Via A. Lissoni 5, 20052 Monza (MI) Italy, Tel: +39 039–321318/039–383907; Fax: +39 039–366390; e-mail:


Objective To compare two types of intervention intended to reduce weight in obese children that can be carried out in the family paediatricians (FPs) office.

Design Controlled prospective study with randomization of FPs into two different treatment groups: routine approach (group A) and enhanced approach (group B).

Settings FPs of certain ASL (Local Health Units) in Lombardy (Northern Italy).

Subjects Obese children (excess weight (≥20% of ideal body weight), aged 3–12 years.

Main outcome measures (1) Variation in percentage overweight; (2) behavioural modifications and (3) adherence to follow-up visits, which was also used as an indicator for FP's commitment.

Results A total of 18 of the 139 (13%) FPs contacted agreed to participate in the study and enrolled 186 children, 114 in group A and 72 in group B. Compared with starting values, a reduction in percentage overweight was observed in both groups. This reduction was significantly higher in group B (–8.8% at 6 months; –8.5% at 12 months) than in group A (–2.9% at 6 months; –2.9% at 12 months). In group B, the observed reduction in weight was associated with the changes in dietary behaviour and with the level of parental involvement. No significant variations in physical activity, computer or television use were noted within each group from 0 to 12 months and between groups at these times. The attendance of children at the 12-month follow-up visit was 70.2% (80/114) in group A and 69.4% (50/72) in group B; however, these values varied considerably when individual FP were considered.

Conclusions This study indicates that FPs who maintain a positive, long-lasting, active contact with obese children and their families can significantly enhance the child's ability to lose weight.