Medical care of obese children and adolescents

Reinehr, Thomas; Wabitsch, Martin; Andler, Werner; Beyer, P; Böttner, Antje; Chen-Stute, Annette; Fromme, Carmen; Hampel, O.; Keller, Klaus; Kilian, U.; Kolbe, Hilde; Lob-Corzilius, Thomas; Marg, W.; Mayer, Hermann; Mohnike, Klaus; Oepen, Johannes; Povel, Clemens; Richter, Brunhild; Riedinger, Nikola; Schauerte, G.; Schmahlfeldt, Gernot; Siegfried, Wolfgang; Smuda, Peer; Stachow, Rainer; Egmond-Fröhlich, A. van; Weiten, Jannie; Wiegand, Susanna; Witte, Sabine; Zindel, Volker; Holl, Reinhard W.

doi:10.1007/s00431-004-1421-1

Cited by 53 publications

(17 citation statements)

References 29 publications

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“…When more than one BMI value was available within one of the above-outlined time intervals, the average BMI was calculated. We defined treatment success using the definition proposed by the AGA Group [18]: a reduction in BMI-SDS of at least 0.2, which corresponds to a weight reduction of 5%, was used to define the success of weight reduction and maintenance in adults.…”

Section: Methodsmentioning

confidence: 99%

“…In the APV cohort, anthropometric parameters are documented routinely according to standardized AGA specifications, as described previously [18]. Weight status was assessed by BMI [body weight (kg)/body height (m) 2 ].…”

Section: Methodsmentioning

confidence: 99%

“…This is a retrospective study with data drawn from the APV (Adiposity Patients Verlaufsbeobachtung) registry, a large database for quality assurance for certified in- and outpatient pediatric obesity treatment centers in Germany, Austria and Switzerland [18]. The APV software enables longitudinal documentation of anthropometric parameters, metabolic control and treatment modalities.…”

Section: Methodsmentioning

confidence: 99%

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Predicting Weight Loss and Maintenance in Overweight/Obese Pediatric Patients

et al. 2014

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Background: Pediatric lifestyle interventions have positive short-term effects on obese patients. Studies on long-term effects are still scarce in Europe. We investigated long-term weight patterns and sociodemographic predictors of a weight change in a large Central European (Germany, Austria and Switzerland) overweight pediatric cohort. Methods: The APV (Adiposity Patients Verlaufsbeobachtung) database was retrospectively analyzed; 157 specialized childhood obesity centers contributed standardized data of 29,181 patients [body mass index (BMI) ≥90th percentile; 5-25 years old] presenting between 2000 and 2012. BMI standard deviation scores (BMI-SDS) were analyzed in a 2-year follow-up and grouped according to BMI-SDS changes. Multiple logistic regression analyses were conducted to assess associations between sociodemographic factors and weight patterns. Results: 2-year follow-up data were available in 3,135 patients (54.6% female). Five distinct weight trajectories ‘rapid weight loss' (n = 735, 23.4%), ‘delayed success' (n = 697, 22.2%), ‘cycling weight' (n = 43, 1.4%), ‘initial weight loss' and ‘weight rebound' (n = 383, 12.2%) and ‘no weight loss throughout' (n = 1,277, 40.7%) best characterized long-term BMI-SDS changes. Younger and male patients were more likely to reduce weight and maintain weight loss. Conclusions: Our results suggest that an intervention before the onset of puberty seems promising for long-term weight maintenance in overweight children. Thus, new concepts are needed to improve long-term treatment success in patients with lower success rates.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Predicting Weight Loss and Maintenance in Overweight/Obese Pediatric Patients

et al. 2014

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“…For the collection of data at the participating APV centers, a user-friendly software, designed for longitudinal patient documentation, was applied [13]. Anthropometric and metabolic parameters were documented at the participating centers, anonymized and transmitted for central analysis.…”

Section: Methodsmentioning

confidence: 99%

“…Two major surveys were performed: the ‘Adipositas Patienten Verlaufsbeobachtung' (APV), an ongoing standardized multicentre documentation initiative, was designed to record weight and cardiovascular risk factors in obese children and adolescents transferred to specialized treatment institutions (http://www.a-p-v.de) [13]. 178 centers specialized in pediatric obesity care (151 out-patient programs, 27 in-patient rehabilitation institutions) in Germany, Austria and Switzerland participated in this survey.…”

Section: Methodsmentioning

confidence: 99%

Comorbidities Related to BMI Category in Children and Adolescents: German/Austrian/Swiss Obesity Register APV Compared to the German KiGGS Study

et al. 2011

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Purpose: To assess cardiovascular risk factors in overweight or obese children and adolescents in Germany, Austria and Switzerland and to investigate the relationship to BMI category. Methods: Data of 63,025 overweight or obese patients (APV population) were compared to normal-weight subjects from a representative study on health status of 14,298 children and adolescents in Germany (KiGGS survey). The weight status was assessed by BMI, and BMI-SDS values were cal-culated using national reference data. Results: In normal-weight KiGGS subjects, mean BMI was 17.3 ± 2.5 (BMI-SDS -0.1 ± 0.8). In the overweight or obese APV population, mean BMI was 30.2 ± 5.6 (BMI-SDS 2.5 ± 0.6). In normal-weight subjects blood pressure, total cholesterol, LDL-cholesterol, and triglycerides were elevated in 6.1, 8.6, 7.0 and 3.0%, respectively, and HDL-cholesterol was reduced in 3.0%, whereas in overweight/obese subjects the percentages of abnormal values were 35.3, 13.8, 14.5, 13.6, and 10.1%, respectively. Conclusions: Cardiovascular risk is increased in obese children and adolescents. There is a strong need to monitor blood pressure and serum lipids in this group of patients. Our results emphasize the importance of prevention of obesity in order to reduce cardiovascular risk.

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Who benefits most from outpatient lifestyle intervention? An IMI‐SOPHIA study on pediatric individuals living with overweight and obesity

Prinz,

Pomares‐Millan,

Dannemann

et al. 2023

Obesity

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ObjectiveThe first‐line approach for childhood obesity is lifestyle intervention (LI); however, success varies. This study aimed first to identify distinct subgroups of response in children living with overweight and obesity and second to elucidate predictors for subclusters.MethodsBased on the obesity patient follow‐up registry the APV (Adipositas‐Patienten‐Verlaufsdokumentation) initiative, a total of 12,453 children and adolescents (median age: 11.5 [IQR: 9.7–13.2] years; BMI z score [BMIz]: 2.06 [IQR: 1.79–2.34]; 52.6% girls) living with overweight/obesity and participating in outpatient LI were studied. Longitudinal k‐means clustering was used to identify individual BMIz response curve for up to 2 years after treatment initiation. Multinomial logistic regression was used to elucidate predictors for cluster membership.ResultsA total of 36.3% of children and adolescents experienced “no BMIz loss.” The largest subcluster (44.8%) achieved “moderate BMIz loss,” with an average delta‐BMIz of −0.23 (IQR: −0.33 to −0.14) at study end. A total of 18.9% had a “pronounced BMIz loss” up to −0.61 (IQR: −0.76 to −0.49). Younger age and lower BMIz at LI initiation, larger initial BMIz loss, and less social deprivation were linked with higher likelihood for moderate or pronounced BMIz loss compared with the no BMIz loss cluster (all p < 0.05).ConclusionsThese results support the importance of patient‐tailored intervention and earlier treatment escalation in high‐risk individuals who have little chance of success.

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Medical care of obese children and adolescents

Cited by 53 publications

References 29 publications

Predicting Weight Loss and Maintenance in Overweight/Obese Pediatric Patients

Predicting Weight Loss and Maintenance in Overweight/Obese Pediatric Patients

Comorbidities Related to BMI Category in Children and Adolescents: German/Austrian/Swiss Obesity Register APV Compared to the German KiGGS Study

Who benefits most from outpatient lifestyle intervention? An IMI‐SOPHIA study on pediatric individuals living with overweight and obesity

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