The multidisciplinary, four-phase approach, which includes PSMF, BEM, and MPE is successful in treating mild, moderate, and severe degrees of childhood and adolescent obesity. The MPE program is appropriate for use with PSMF and BEM due to its progressive nature, variety of options, and moderate intensity level. In addition, the MPE program is of sufficient intensity, duration, and frequency to promote a significant increase in estimated aerobic capacity (VO2max) and to promote the maintenance of lean body mass and resting energy expenditure. The short-term intervention of PSMF, BEM, and MPE also results in an improvement in body composition, lipid profiles, and IGF-1 and T3 levels. The 1200-calorie balanced diet, MPE, and BEM also provide a successful method of weight maintenance in children and adolescents, as indicated by further improvement in body composition at the 26-week measure. Additional studies are needed to assess the contribution of exercise to the maintenance of lean body mass and resting energy expenditure in obese children and adolescents. In addition, it will be important to assess long-term weight maintenance in obese adolescents who effectively lose weight in this multidisciplinary program.
The prevalence of obesity in American youth is increasing and treatment of the condition is difficult. We have developed a multi‐disciplinary weight reduction program that extends over 1 y and includes a very low‐calorie diet (VLCD) followed by a hypocaloric diet, exercise, and behavior modification. Based on data collected at baseline, at the end of the acute intervention phase (10–20 wk), and at 1‐y evaluation, we assessed the efficacy of this outpatient weight reduction program in treating obese children and adolescents in a follow‐up of a series of cases. Furthermore, we examined the impact of the approach on growth velocity and maintenance of weight loss at 1 y. Fifty‐six overweight children (aged 7–17 y) were recruited during a period of 18 mo to participate in the weight management program; 52 (93%) completed the acute phase of treatment and 35 (62.5%) successfully completed the I‐y program. There was a significant decrease in body weight and body fat, as assessed by weight determinations and skinfold measurements 0, < 0.0001; results not corrected for age). The body mass index for the 35 individuals who completed the 1‐y program decreased significantly from 32.7 on entry to 28.72 at 1 y (p < 0.0001; results not corrected for age).
Conclusion: We conclude that a multidisciplinary weight reduction program that combines a VLCD, followed by a balanced hypocaloric diet, with a moderate‐intensity progressive exercise program and behavior modification is an effective means for weight reduction in obese children and adolescents.
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