Sustainable weight loss over three years in children with obesity: a pragmatic family-centered lifestyle intervention

Eat Weight Disord. 2021 Mar;26(2):537-545. doi: 10.1007/s40519-020-00887-7. Epub 2020 Mar 13.

Abstract

Introduction: Childhood obesity has psychological consequences and increases the risk of continuous obesity into adulthood, associated with development of non-communicable disease (e.g. type 2 diabetes). Short-term weight loss intervention studies show good results but long-term studies are limited.

Methods: One hundred ninety-nine obese children (4-18 years of age), with a BMI-SDS (standard deviation score) above + 2 SDS were enrolled into a multifactorial family-centered lifestyle intervention study. The children had yearly visits in the outpatient clinic for anthropometrics, blood samples and DXA-scans, and 6-8 meeting with community health workers between these visits. The children followed the intervention up to 3 years.

Results: After a follow-up of 26.7 ± 17.5 months a reduction in BMI-SDS of - 0.25 SDS (p < 0.001) was observed. The 57 children who were adherent to the intervention for ≥ 2 years had significantly reduced BMI-SDS compared to the 142 children with shorter intervention (BMI-SDS: - 0.38 ± 0.67 vs. - 0.20 ± 0.50, p = 0.036). All weight loss was accompanied by decrease in fat mass and increase in muscle mass (p < 0.001).

Conclusion: The intervention was found to induce long-term reduction in BMI-SDS in obese children, with beneficial change in body composition. Children who followed the intervention the longest had the greatest reduction in BMI-SDS.

Level of evidence: Level III, longitudinal cohort study.

Keywords: Body composition; Children; Lifestyle intervention; Long-term; Obesity; Weight loss.

MeSH terms

  • Adult
  • Body Mass Index
  • Child
  • Diabetes Mellitus, Type 2*
  • Humans
  • Life Style
  • Longitudinal Studies
  • Pediatric Obesity* / therapy
  • Weight Loss