Article

Importance of Age for 3-Year Continuous Behavioral Obesity Treatment Success and Dropout Rate

Division of Pediatrics, Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, Stockholm, Sweden.
Obesity Facts (Impact Factor: 2.25). 03/2012; 5(1):34-44. DOI: 10.1159/000336060
Source: PubMed

ABSTRACT

To assess whether first year weight loss, age, and socioeconomic background correlate with the success rate of continuous long-term behavioral obesity treatment.
In a 3-year longitudinal study, obese children (n = 684) were divided into three groups based on age at the start of treatment, age 6-9 years, 10-13 years, and 14-16 years. RESULTs: The mean BMI standard deviation score (BMI-SDS) decline was age-dependent (p = 0.001), independently of adjustment for missing data: -1.8 BMI-SDS units in the youngest, -1.3 in the middle age group, and -0.5 in the oldest age group. SES and parental BMI status did not affect the results. 30% of the adolescents remained in treatment at year 3. There was only a weak correlation between BMI-SDS change after 1 and 3 years: r = 0.51 (p < 0.001). Among children with no BMI-SDS reduction during year 1 (n = 46), 40% had a clinically significantly reduced BMI-SDS after year 3.
Behavioral treatment should be initiated at an early age to increase the chance for good results. Childhood obesity treatment should be continued for at least 3 years, regardless of the initial change in BMI-SDS.

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    • "With infants and toddlers, parents can make all feeding decisions and respond to the child with a simple yes or no; responding to a preschooler's food demands, however , is more complex. The preschool age is therefore a crucial time in which parents develop communication about food with their children[1]; indeed, previous studies have shown that obesity interventions may be most effective in the preschool age range[14,15]. The preschool age is a time when distinct eating behaviors are formed[16]. "
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    • "From a clinical perspective, our results suggest that family-centered interventions such as the FCU can have a positive impact on family processes, which may in turn impact adolescent health in a manner that is carried forward into adulthood, even if the program does not include components related to nutrition or physical activity. This is especially promising as targeting obesity in adolescents through traditional means (focusing on obesity-related behaviors) continues to produce very modest results (Danielsson et al., 2012). As noted by Gerards and colleagues (2011), few obesity prevention and intervention programs address broader aspects of parenting, and our findings can spur the development of new programs by suggesting specific mechanisms by which the family can influence adolescent and early-adult health. "
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    ABSTRACT: The prevalence of obesity among adolescents has increased and we lack effective treatments.
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