Recent Advances in the Treatment of Childhood Obesity

Abstract

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.

A Meta-Analysis of Obesity Interventions Among U.S. Minority Children

“…It is noteworthy that other studies that included only black girls [105,123] and that used passive internet interventions experienced an increase in BMI post-test or a weak effect on reducing BMI. This might be due to the lack of lifestyle change strategies, a passive internet health education web site, and low [97,99,101,108], a four-phase multidisciplinary weight reduction program including lifestyle change approaches and parental involvement, succeeded in reducing main outcome measures. One study [108] conducted among 56 children (21% Black) yielded a 4.10 kg/m 2 reduction in BMI in 1 year and the greatest effect size (d ¼ 3.28) in this meta-analysis.…”

“…This might be primarily because of the fact that children attended weekly two-hour sessions with their parents for 1 year, and parents were involved in all aspects of those weekly sessions. Despite the successful results, the interpretation of them warranted caution for the following reasons: none of the four Committed to Kids studies [97,99,101,108] used a control group, and two [97,108] of them suffered high dropout rates (i.e., 37.5% and 39.8%). Thus, extraneous confounders might have accounted for part of the findings [134].…”

The outcome of childhood obesity management depends highly upon patient compliance

“…Reviewing intervention studies unveils heterogenous data on the short-and long-term effectiveness of weight reduction programmes for children and adolescents [2, 3,5,17,18,19,22,23,24,25,26,28] with limited comparability due to methodological issues (reference values, chosen parameters, sample size), and rarely presenting data on the problem of patientsÕ compliance and drop-out rates in the practice of clinical childhood obesity treatment [21]. Positive outcomes have mostly been reported for integrated behavioural intervention programmes [6,10,12,24] requiring a considerably high willingness of patients and parents to undergo time-intensive treatment. An extensive literature review on outcome studies with a focus on behavioural intervention has been published recently by Epstein and co-workers [9].…”

Promoting healthy lifestyles: Behavior modification and motivational interviewing in the treatment of childhood obesity

“…However, longer treatments present challenges in maintaining participants in treatment. 73 Additionally, given findings from a multidisciplinary weight management program for obese children that demonstrated the efficacy of a progressive exercise program used in conjunction with behavior-modification sessions, 74 the inclusion of exercise regimens as a treatment component should be considered in future research. Future research should also move beyond traditional clinic-based models and examine other intervention methods that can increase the percentage of children who are able to lose and maintain weight losses.…”