Funding source: Thomas Reinehr: received grant support from of the German Ministry of Education and Research (Bundesministerium für Bildung und Forschung Obesity network: grant number 01 01GI1120A and 01GI 1120B).
Extremely obese children respond better than extremely obese adolescents to lifestyle interventions
Article first published online: 17 DEC 2013
© 2013 The Authors. Pediatric Obesity © 2013 International Association for the Study of Obesity
Volume 10, Issue 1, pages 7–14, February 2015
How to Cite
Knop, C., Singer, V., Uysal, Y., Schaefer, A., Wolters, B. and Reinehr, T. (2015), Extremely obese children respond better than extremely obese adolescents to lifestyle interventions. Pediatric Obesity, 10: 7–14. doi: 10.1111/j.2047-6310.2013.00212.x
Financial disclosure statement: nothing to disclose.
Study registration: This study is registered at clinicaltrials.gov (NCT00435734).
- Issue published online: 22 JAN 2015
- Article first published online: 17 DEC 2013
- Manuscript Accepted: 20 OCT 2013
- Manuscript Revised: 15 OCT 2013
- Manuscript Received: 17 JUL 2013
- German Ministry of Education and Research. Grant Numbers: 01 01GI1120A, 01GI 1120B
- extreme obesity;
- weight loss
- Lifestyle intervention is regarded as therapy of choice in obese children and adolescents.
- It is unclear whether extremely obese children and adolescents respond to lifestyle intervention.
- Extremely obese children respond better than obese children to a lifestyle intervention.
- In contrast, most extremely obese adolescents achieved no weight loss in lifestyle intervention suggesting that other treatment approaches are needed for them.
There are conflicting results of treating extreme obesity in childhood by lifestyle interventions in the literature.
We analysed the outcome of a 1-year lifestyle intervention in an intention-to-treat approach in 1291 children (mean age 11.0 ± 2.5 years, mean body mass index [BMI] 27.5 ± 4.7 kg m−2, 55.8% female, 62.4% obese, 37.6% extremely obese (defined by BMI-SDS >2.3) at end of intervention and 1 year later.
The mean BMI-SDS reduction was −0.20 ± 0.32 at end of intervention and −0.14 ± 0.37 1 year after end of intervention compared to baseline (comparing intervention vs. 1 year later P = 0.010). Extremely obese children ≤10 years demonstrated a significantly greater BMI-SDS reduction than obese children ≤10 years (−0.24 ± 0.38 vs. −0.16 ± 0.38, P = 0.021). Extremely obese adolescents >10 years demonstrated a significantly lower BMI-SDS reduction compared to obese adolescents >10 years (−0.05 ± 0.30 vs. −0.15 ± 0.39, P < 0.001). Comparing the BMI-SDS reduction between obese children <10 years and >10 years revealed no significant difference (P = 0.195) in contrast to the comparison between extremely obese children <10 years and >10 years (P < 0.001). The same findings were observed in the follow-up period after the end of intervention.
Our study demonstrated an encouraging effect of lifestyle intervention in extremely obese children ≤10 years at the end of intervention and 1 year later, but only a limited effect in extremely obese adolescents >10 years.