A Three-year Behavioral Treatment of Obese Children
Condition: Childhood Obesity
MeSH terms: Pediatric Obesity
Study type: Interventional

Summary: 
      The prevalence of overweight and obesity among children and adolescents has reached epidemic
      proportions worldwide. Among Swedish 10-year old children 15-20% are overweight and 3-5% are
      obese. The probability that an obese child becomes an obese adult is very high. This chronic
      disease requires lifetime treatment. The standard treatment of childhood obesity involves
      behavioural interventions focused on eating habits and physical activity. Studies often
      include small study samples, the absence of control groups and short treatments times.
      Several long-term follow-up studies of shorter interventions are available. The results from
      these studies are disappointing since the number of children who are "cured" i.e., have
      become non-obese is low. Thus, effective treatments are currently lacking.The National
      Childhood Obesity Center treats children in a University hospital setting. The children are
      enrolled from the catchment areas of the hospital as well as the rest of Sweden. Treatment
      alternatives include behavioural treatment (individual and group), low and very low calorie
      diet, pharmacological and surgical treatment. Patients treated with surgical and
      pharmacological methods safety is ensured using these treatments exclusively in controlled
      studies. The clinic was the first in Sweden with this wide range of treatment options.

      BORIS is a national health care quality register for childhood obesity, supervised by the
      Swedish Association of Local Authority and Regions.
    

Detailed description: 
      The primary aim of this study was to compare treatment effects (changes in BMI SDS) during
      the first three years of behavioral treatment in relation to age at start of treatment. The
      secondary aim was to evaluate specific factors of importance (gender, heredity, parental
      weight status, socioeconomic factors and age at obesity onset) for treatment effects. The
      third aim was to investigate factors correlated to drop out.

      This is a longitudinal study of all patients referred to National Childhood Obesity Center
      between January 1997 and December 2004. Only patients with behavioral treatment were
      included. Patients with other treatments (VLCD/LCD, drugs and surgery) and other diagnoses
      (syndromes, craniopharyngioma, Mb Down, myelomeningocele, various types of mental and
      psychological disorders) and children <6 and >17 year at inclusion were excluded. The
      remaining children were divided into three age groups of obese children depending of age at
      onset of obesity treatment (6-9, 10-13 and 14-16year). All patient data were registered in
      the BORIS nationwide childhood obesity database.
    

Intervention name(s): Individually and in groups
Intervention type(s): Behavioral
Intervention description(s): During three year in a clinical setting.
Allocation: Non-Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: Childhood obesity; Age-dependent; Long-term treatment; BMI SDS; Dropouts