An Effective Multidisciplinary Approach to Weight Reduction in Youth

Sothern, M. S.; Almen, T. Kristian von; Schumacher, H.; Zelman, Mitchell; Farris, Rosanne P.; Carlisle, Lauren Keely; Udall, J. N.; Suskind, Robert M.

doi:10.1111/j.1749-6632.1993.tb18870.x

Cited by 17 publications

(15 citation statements)

References 3 publications

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“…Most studies were published in the 1990s (n = 13), seven in the 1980s and four since 2000. Most were conducted in the United States (n = 13), with the remaining conducted in either Austria (n = 6), Italy (n = 4), or Australia (n = 1) . Most were pre‐post studies (n = 16), with other study types including four nonrandomized comparison studies, two randomized controlled trials, and two chart reviews …”

Section: Resultsmentioning

confidence: 99%

“…Six studies had less than 10 participants . Seven of the interventions incorporated an inpatient phase of at least 1 week, 15 were outpatient based, and two did not describe the intervention setting …”

Section: Resultsmentioning

confidence: 99%

“…Obesity was defined by a variety of measures, including percentage above individual ideal body weight (IBW), weight‐for‐height, and BMI. Five studies recruited participants whose weight was greater than or equal to 120% of their IBW, one recruited participants whose weight was greater than or equal to 130% of their IBW, and another recruited participants whose weight was greater than 200% of their IBW . IBW was calculated using data from the National Center for Health Statistics (NCHS) in all except one study, where Metropolitan Life Insurance Tables, which presents medium weight for height data, were used to define obesity as weight greater than 200% of IBW .…”

Section: Resultsmentioning

confidence: 99%

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Efficacy of very low‐energy diet programs for weight loss: A systematic review with meta‐analysis of intervention studies in children and adolescents with obesity

et al. 2019

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The objective of this review was to evaluate the efficacy and safety of very low-energy diet (VLED) programs for weight loss in children and adolescents with obesity. Six electronic databases were searched identifying 24 eligible studies (16 pre-post studies, four nonrandomized trials, two randomized controlled trials [RCTs], and two chart reviews) published up to October 2018. Studies were in English, implemented a VLED (≤3360 kJF/day [≤800 kcal/day] or <50% estimated energy requirements) in 5-to 18-year-olds with obesity, and reported at least one weight-related outcome. Weight-related outcomes significantly improved postintervention in all studies. Meta-analysis of 20 studies indicated a mean 10.1 kg (95% confidence interval [CI], 8.7-11.4 kg, P < 0.001; I 2 = 92.3%) weight loss following interventions lasting 3 to 20 weeks. Moderator analysis indicated greater weight loss in adolescent-only studies (10-18 years) and formulated meal replacement interventions and inpatient settings. Meta-analysis of seven studies reporting weight at follow-up (5-14.5 months from baseline) indicated 5.3 kg mean weight loss (CI, 2.5-8.0 kg, P < 0.001; I 2 = 50.6%). Details of adverse events were limited. VLED programs are effective for treating children and adolescents with obesity. However, conclusions on their safety cannot be drawn from the existing literature at this time. Future studies should include long-term follow-up with ongoing support and comprehensive monitoring of all adverse events.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Efficacy of very low‐energy diet programs for weight loss: A systematic review with meta‐analysis of intervention studies in children and adolescents with obesity

et al. 2019

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“…It has proven inadequate probably because the sociological factors are not taken into account. Medical treatment approaches for obesity have largely been developed in modern societies and appear to be effective on the short term [8], [9]. However, data reporting on long-term health outcome based on successful treatment strategies are very limited [10].…”

Section: Introductionmentioning

confidence: 99%

Plasma and Liver Lipidomics Response to an Intervention of Rimonabant in ApoE*3Leiden.CETP Transgenic Mice

Wei²,

Hoek³

et al. 2011

PLoS ONE

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BackgroundLipids are known to play crucial roles in the development of life-style related risk factors such as obesity, dyslipoproteinemia, hypertension and diabetes. The first selective cannabinoid-1 receptor blocker rimonabant, an anorectic anti-obesity drug, was frequently used in conjunction with diet and exercise for patients with a body mass index greater than 30 kg/m2 with associated risk factors such as type II diabetes and dyslipidaemia in the past. Less is known about the impact of this drug on the regulation of lipid metabolism in plasma and liver in the early stage of obesity.Methodology/Principal FindingsWe designed a four-week parallel controlled intervention on apolipoprotein E3 Leiden cholesteryl ester transfer protein (ApoE*3Leiden.CETP) transgenic mice with mild overweight and hypercholesterolemia. A liquid chromatography–linear ion trap-Fourier transform ion cyclotron resonance-mass spectrometric approach was employed to investigate plasma and liver lipid responses to the rimonabant intervention. Rimonabant was found to induce a significant body weight loss (9.4%, p<0.05) and a significant plasma total cholesterol reduction (24%, p<0.05). Six plasma and three liver lipids in ApoE*3Leiden.CETP transgenic mice were detected to most significantly respond to rimonabant treatment. Distinct lipid patterns between the mice were observed for both plasma and liver samples in rimonabant treatment vs. non-treated controls. This study successfully applied, for the first time, systems biology based lipidomics approaches to evaluate treatment effects of rimonabant in the early stage of obesity.ConclusionThe effects of rimonabant on lipid metabolism and body weight reduction in the early stage obesity were shown to be moderate in ApoE*3Leiden.CETP mice on high-fat diet.

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“…Unfortunately, few effective treatment options exist for obese children. Interventions that include behavioral change (2) and multidisciplinary treatment teams (3) have yielded some success, but effective options for childhood weight management are still limited, especially for high‐risk populations (1,4). Also, little is known about effective obesity treatments for children who are poor, have multiple comorbidities, or are morbidly obese (5).…”

mentioning

confidence: 99%

A Pediatric Weight Management Program for High‐risk Populations: A Preliminary Analysis

Skelton

DeMattia

Flores

2008

Obesity

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Objective: To determine whether a multidisciplinary pediatric weight management program effectively improves BMI, BMI z-score, and cardiovascular risk factors (CVRFs) in high-risk populations. Methods and Procedures: A retrospective chart review was performed on children seen in the NEW Kids Program at the Children's Hospital of Wisconsin, a family-based clinic that treats pediatric obesity using medical management, nutrition education, behavioral intervention, and physical activity. Inclusion criteria were program participation for ≥9 months and >4 visits. Analyses were performed to identify factors associated with pre-to postintervention changes in BMI, BMI z-score, and CVRF laboratory values. Results: A total of 66 patients met inclusion criteria; the mean age was 11 years (s.d. ± 3.4), 56% were racial/ethnic minorities, 45% were Medicaid recipients, 48% resided in impoverished communities, and 38% had a BMI ≥40 kg/m 2 . Of the 66 patients, 91% had more than one weight-related comorbidity, 88% had CVRFs, and the preintervention mean BMI was 37 kg/m 2 . After the intervention, there was an overall increase in absolute BMI, but a small, yet significant decrease in BMI z-score (mean -0.03 ± 0.16; P < 0.05). There were significant pregroup to postgroup improvements in total cholesterol, low-density lipoprotein, and triglycerides levels (P < 0.05). Insurance coverage, race/ethnicity, gender, age, and initial BMI were not significantly associated with changes in BMI or BMI z-score. Discussion: A multidisciplinary pediatric weight management program can improve the weight status of high-risk populations, including minorities, Medicaid recipients, patients with multiple comorbidities and CVRFs, and the severely obese.

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An Effective Multidisciplinary Approach to Weight Reduction in Youth

Cited by 17 publications

References 3 publications

Efficacy of very low‐energy diet programs for weight loss: A systematic review with meta‐analysis of intervention studies in children and adolescents with obesity

Efficacy of very low‐energy diet programs for weight loss: A systematic review with meta‐analysis of intervention studies in children and adolescents with obesity

Plasma and Liver Lipidomics Response to an Intervention of Rimonabant in ApoE*3Leiden.CETP Transgenic Mice

A Pediatric Weight Management Program for High‐risk Populations: A Preliminary Analysis

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