Effects of long-term multidisciplinary inpatient therapy on body composition of severely obese adolescents

Prado, Wagner Luiz do; Siegfried, Alena; Dâmaso, Ana Raimunda; Carnier, June; Piano, Aline de; Siegfried, Wolfgang

doi:10.2223/jped.1889

Cited by 19 publications

(28 citation statements)

References 24 publications

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“…Earlier studies using very low calorie diets and moderate vigorous physical activity resulted in loss of LM in adults and children . Subsequent intensive inpatient studies demonstrated maintenance of LM . In this study, which used a moderate calorie restriction, LM was preserved in boys and that although the absolute LM decreases in girls, the percentage of weight that is LM continues to increase.…”

Section: Discussionmentioning

confidence: 59%

Change in body composition during a weight loss trial in obese adolescents

et al. 2013

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Background Changes in body composition during weight loss among obese adolescents are poorly understood. This study characterized the composition of weight loss, and its association with changes in waist circumference (WC) in obese adolescents. Methods Total (Tot), trunk (Tr) and appendicular (Ap) fat mass (FM) and lean mass (LM) were measured by dual-energy X-ray absorptiometry (DXA) in 61 obese adolescents (40 girls) who participated in a randomized-controlled weight-loss trial. Changes in body composition were assessed at 0, 6, and 12 months using mixed-effects regression models. Correlation analysis of change in WC and total and regional compartments of FM and LM were also assessed. Results Weight-loss for adolescents was 90.3% FM and 15.9% LM at 0–6mo, and 98.2% FM and 7% LM at 0–12 mo. At 12mo, girls lost 2.67 kg more TotFM than boys in models adjusted for height, age, race, and baseline weight. Boys gained LM in all compartments in all models. At 12mo, girls lost TotLM (2.23 ±0.74, p<0.004) and ApLM (0.69 ±0.31, p=0.03), and gained TrLM (0.37±0.35, p=0.29). The percentage LM, increased for boys and girls in all models. TotFM was correlated with BMI change with TotFM (R=0.70–0.91, p=0.001) and WC change (R=0.53–0.55, p<0.001). Conclusions Weight loss in obese adolescents during a weight-loss trial using lifestyle management and sibutramine was primarily from trunk fat mass. Although absolute LM increased in boys and decreased in girls, the percentage of weight that is LM increased for both boys and girls. Changes in BMI were more reflective of changes in FM than changes in WC.

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Section: Discussionmentioning

confidence: 59%

Change in body composition during a weight loss trial in obese adolescents

et al. 2013

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“…However, over 25% of the excess weight in obese adolescents is attributed to elevations in FFM (14) . Therefore, if the common, yet conflicting, goals of retaining or increasing FFM while subsequently maximizing weight loss (15,16) are to be realized, weight management strategies may need to emphasize one goal over the other.…”

Section: Introductionmentioning

confidence: 99%

The contribution of fat-free mass to resting energy expenditure: implications for weight loss strategies in the treatment of adolescent obesity

Browning

Evans

2015

International Journal of Adolescent Medicine and Health

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Owing to the strong relationship between fat-free mass (FFM) and resting energy expenditure (REE), the preservation of FFM is often emphasized in the treatment of adolescent obesity. Typical treatment regimens including an increased dietary consumption of protein and participation in resistance training are common components of adolescent weight management programs, despite limited evidence of a positive influence of FFM on weight loss outcomes in adolescents. Given the larger volume of FFM in obese relative to normal weight adolescents and the common treatment goals of both maximizing weight loss and attenuating the loss of FFM, a better understanding of the influence of FFM on energy balance is needed to determine whether strategies to preserve lean tissue or maximize absolute weight loss should be most emphasized. We review the associations among FFM, REE, and weight loss outcomes, focusing on how these relationships might influence energy balance in obese adolescents.

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“…The most important effects of the multidisciplinary treatment on the population investigated include improvements in the anthropometric parameters, such as the reduction in Total Body Mass (TBM) 5 36 found a significant reduction in body weight, BMI, and body fat after a nine-month intervention.…”

Section: Discussionmentioning

confidence: 99%

Multidisciplinary programs for obesity treatment in Brazil: A systematic review

et al. 2016

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This study aimed to conduct a systematic review of publications addressing the multidisciplinary treatment of obesity in Brazil and analyze their main results. A search was conducted in the databases SciELO, Lilacs, and Pubmed/Medline using the following search terms: 'obesidade', 'intervenção', 'tratamento', 'Brasil', for the search in Portuguese, and 'obesity', 'intervention', 'treatment', 'Brazil', for the search in English. Based on these terms, the following combination of words was used: 'Intervenção multiprofissional da obesidade', 'tratamento multidisciplinar da obesidade, tratamento multiprofissional da obesidade' and 'multidisciplinary obesity intervention', 'multidisciplinary obesity treatment', 'Multiprofessional obesity treatment'. Inclusion criteria were as follows: original studies carried out in Brazil involving human beings and that reported an intervention including two or more health care professionals. Articles published between January 2005 and July 2015 were analyzed independently by two reviewers. At the end of the analysis, out of 355 articles initially selected, 26 met all inclusion criteria. The following results were found: 23 studies involved children and adolescents and 03 involved adults 20-60 years of age. It was also found that the 26 studies analyzed had an impact on anthropometric parameters, 10 on physical fitness parameters, 16 on biochemical parameters, 10 on the reduction in comorbidities, 6 on nutritional parameters, and 4 on the psychological/social aspects. Based on evidence presented in the studies reviewed, it can be said that the multidisciplinary treatment for obesity greatly contributed to the reduction in the anthropometric indicators, especially BMI and the biochemical, social, and psychological parameters. Thus, these findings demonstrate that there is a need to expand the range of this type of treatment since it has proven to be effective in the fight against obesity and its comorbidities.

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Effects of long-term multidisciplinary inpatient therapy on body composition of severely obese adolescents

Cited by 19 publications

References 24 publications

Change in body composition during a weight loss trial in obese adolescents

Change in body composition during a weight loss trial in obese adolescents

The contribution of fat-free mass to resting energy expenditure: implications for weight loss strategies in the treatment of adolescent obesity

Multidisciplinary programs for obesity treatment in Brazil: A systematic review

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