There is a need for more flexible treatment strategies to help patients reach relevant treatment outcomes and adhere better to treatment. The aim of this study was to evaluate the long-term efficacy, in terms of patients' weight status, of replacing usual care (UC) physical visits with more frequent but shorter telephone coaching (TC) sessions as part of a structured childhood obesity treatment. In this controlled study, patients aged 5-14 years from the Södertälje outpatient clinic, Sweden were randomized to either UC or TC over an 18-month period after participating in an initial standard obesity treatment programme. The patients were followed for a mean of 3.7 years. In total, 37 children (UC, n = 18 and TC, n = 19) were included, with a mean (standard deviation, SD) age of 9.5 (2.6) years and a body mass index standard deviation score (BMI SDS) of 2.9 (0.7). The change in BMI SDS did not differ between the groups during the study (P = 0.8). Both groups had similar changes in BMI SDS 3.7 years after the first visit to the clinic, TC = - 0.42 and UC = 0.52 BMI SDS units (P = 0.6 between groups). There were no gender differences. Furthermore, the average time clinicians spent with each patient during the study did not differ between the groups (P = 0.5). No patients were lost to follow-up during the study. In conclusion, the use of TC may offer greater flexibility in the treatment of paediatric obesity as it was non-inferior for both treatment efficacy and the time spent on treatment by healthcare personnel.
Background: Obesity constitutes a critical risk for adolescent health. This study aimed at identifying youth-friendly components of obesity treatment.
Methods:In this feasibility study, an adolescent obesity treatment platform was implemented at two Pediatric outpatient clinics in Sweden. Body mass index (BMI), BMI z-score, and the category of obesity (International Obesity Task Force) were compared before and after the intervention and with data on standard care from the Swedish Childhood Obesity Treatment Register.
Results:The study included 99 participants (49 females) aged 13-18 years from 1 September 2014, to 31 December 2016. A pediatric nurse met the participants on average 6.5 times in the average inclusion period of 15 months. Physical activity sessions attracted 63 participants. Acceptance Commitment Therapy and In Real Life groups attracted 24 participants. At inclusion, 62 participants had obesity and 37 severe obesity, and 71/99 (72%) remained in the same category. The mean BMI increased from 32.0 to 33.4 kg/m 2 (p < 0.01), but 56/94 (60%) participants lowered their BMI or increased less than 1 kg/m 2 and 73% stayed to the end of the study.Participants who were new to treatment and participants coming for more than eight visits to the nurse did not increase in BMI. BMI did not change for the 221 out of 641 register patients who had two recordings of BMI in the study period.
Conclusions:The platform was successful in increasing retention, and 60% of participants lowered or maintained their BMI. Still, seven out of ten adolescents with obesity or severe obesity remained in the same weight category.
Gender inequality in the couple relationship might contribute to the experience of musculoskeletal pain in both women and men. The results highlight the potential adverse bodily consequences of living in unequal relationships.
AimTo investigate the implementation of a plan of action for treatment of childhood obesity, and the effect after 2 years of treatment.MethodsChildren aged 6‐12.9 years who started obesity treatment between 2008 and 2015 in a paediatric clinic in Stockholm County were included. The treatment model included staff education and support and group activities for parents and children separately followed by individual sessions to a multidisciplinary team. The main outcome was change in body mass index standard deviation score (BMI SDS), in comparison to a matched control group.ResultsIn the intervention group, 1334 children (52% boys) with an average age of 9.3 years and BMI SDS of 2.7 and 3012 children in the control group were included. The intervention group decreased their BMI SDS more after two years compared with the control group, (−0.31 vs −0.23, P < .001). Younger age and higher BMI SDS at treatment initiation and families that completed the group sessions (all P < .001) had greater decreases in BMI SDS after 2 years. Sex did not affect the outcome.ConclusionEven though the treatment in the control group was effective, the implementation of the action plan yielded a better treatment response compared with the control group.
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