The outcome of childhood obesity management depends highly upon patient compliance

Denzer, Christian; Reithofer, Eva; Wabitsch, Martin; Widhalm, Kurt

doi:10.1007/s00431-003-1376-7

Cited by 83 publications

(69 citation statements)

References 19 publications

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“…First, compared with intervention studies based on dietary restrictions, drugs, and/or lifestyle modifications, our study was relatively small; however, it should be recalled that morbid obesity represents ϳ5% of all cases of obesity (39). Second, even though the rate of dropouts was low in this study, obesity studies are usually affected by high rates of dropouts, whether they are diet (40) or surgery (23) studies. Third, this was an observational study, not a randomized clinical trial, but we have no reason to suspect that the large differences between the groups were the result of confounding factors.…”

Section: Clinical and Metabolic Outcomesmentioning

confidence: 96%

Laparoscopic Gastric Banding Prevents Type 2 Diabetes and Arterial Hypertension and Induces Their Remission in Morbid Obesity

et al. 2005

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OBJECTIVE -Lifestyle modifications and pharmacological interventions can prevent type 2 diabetes in obese subjects with impaired glucose tolerance. The aim of this study was to compare laparoscopic adjustable gastric banding (LAGB) and conventional diet (No-LAGB) in the prevention (primary intervention study; 56 vs. 29 patients) and remission (secondary intervention study; 17 vs. 20 patients) of type 2 diabetes and hypertension in grade 3 obesity in a 4-year study.RESEARCH DESIGN AND METHODS -The subjects (n ϭ 122; age 48.5 Ϯ 1.05 years; BMI 45.7 Ϯ 0.67 kg/m 2 ) underwent a diagnostic workup, including psychological and psychiatric assessments, in preparation for the LAGB procedure. Of the 122 subjects, 73 had the surgery (LAGB group). The control group (No-LAGB group) consisted of the 49 subjects who refused the surgery but agreed to be followed up; 6 of these subjects dropped out by the 2nd year of the study, so that the final number of patients was 73 and 43 in the LAGB and No-LAGB groups, respectively. All patients had a yearly visit and oral glucose tolerance test.RESULTS -From baseline to the end of the 4-year follow-up, BMI decreased from 45.9 Ϯ 0.89 at baseline to 37.7 Ϯ 0.71 kg/m 2 in the LAGB group and remained steady in the No-LAGB group (from 45.2 Ϯ 1.04 to 46.5 Ϯ 1.37 kg/m 2 ), with no significant differences between the primary and secondary intervention groups. In the primary intervention study, five of the No-LAGB subjects (17.2%) and none of the LAGB subjects (0.0%; P ϭ 0.0001) progressed to type 2 diabetes; in the secondary intervention study, type 2 diabetes remitted in one No-LAGB patient (4.0%) and seven LAGB patients (45.0%; P ϭ 0.0052). Hypertension occurred in 11 No-LAGB patients (25.6%) and 1 LAGB patient (1.4%; P ϭ 0.0001) and remitted in 1 No-LAGB (2.3%) and 15 LAGB patients (20.5%; P ϭ 0.0001). A study of body mass composition revealed a significant reduction of fat mass and a transitory, but not significant, decrease of fat-free mass in LAGB patients.CONCLUSIONS -In morbid obesity, sustained and long-lasting weight loss obtained through LAGB prevents the occurrence of type 2 diabetes and hypertension and decreases the prevalence of these disorders. Diabetes Care 28:2703-2709, 2005O besity is a major risk factor for certain diseases, particularly cardiovascular disease. The risk is proportional to BMI and duration of obesity and increases with visceral obesity (1-6). Obesity, especially when associated with impaired glucose tolerance (IGT), is a leading cause of type 2 diabetes (7). Several large studies have demonstrated that it is possible to prevent the progression from IGT to type 2 diabetes by dietary intervention, lifestyle modifications (including physical activity), and drugs (8 -13). In some cases, these therapeutic approaches reduce cardiovascular morbidity and mortality in type 2 diabetes (14,15). Obesity and type 2 diabetes are often complicated by arterial hypertension, a link that is allegedly mediated by increased sympathetic tone (16); left ventricular hypertrophy is f...

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Section: Clinical and Metabolic Outcomesmentioning

confidence: 96%

Laparoscopic Gastric Banding Prevents Type 2 Diabetes and Arterial Hypertension and Induces Their Remission in Morbid Obesity

et al. 2005

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“…However, it has been suggested that the type, intensity, and duration of exercise of lifestyle intervention programs to promote weight loss in obese youth should be based on producing an acceptable adherence to exercise programs. (13,18) The duration of the interventions of the included studies ranged from three months to one year.…”

Section: Discussionmentioning

confidence: 99%

The Effect of Diet or Exercise on Visceral Adipose Tissue in Overweight Youth

Vissers

Hens

Hansen

et al. 2016

Medicine &Amp; Science in Sports &Amp; Exercise

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Objective: Excess visceral adipose tissue (VAT) in children with obesity is associated with development of cardiovascular and metabolic disease. This meta-analysis investigated if lifestyle interventions can reduce VAT in overweight and obese youth. Methods:Pubmed, Cochrane and PEDro were searched for clinical trials that objectively assessed VAT and included study arms with supervised diet, exercise or a combination. If there was a "no-therapy" control group, the data of the control group and the intervention groups were used to meta-analyze the data. In all other cases the pre-intervention and the post-intervention data were used to meta-analyze. Effect sizes were calculated as standardized mean differences or changes of VAT and expressed as Hedges"g. Results:The overall weighted mean effect size on VAT of all included interventions was - Conclusions: Supervised exercise-only or combined diet and exercise interventions can reduce VAT in overweight and obese children and adolescents. The strongest effect was found in exercise-only groups. However, high quality RCT"s describing the effect of supervised dietary interventions on VAT in children are lacking.

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“…This is a significant reduction since high levels of soda consumption can be the main source of simple sugars in the diet, bringing with it a consequent caloric impact. 36 Compliance with childhood obesity management proposals is poor, 37 constituting one of the greatest obstacles to treatment. 38 This fact was also observed in the current study.…”

Section: Discussionmentioning

confidence: 99%

Atendimento ambulatorial individualizado versus programa de educação em grupo: qual oferece mais mudança de hábitos alimentares e de atividade física em crianças obesas?

Mello¹,

Luft²,

Meyer³

2004

J. Pediatr. (Rio J.)

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Objective: To compare two strategies for childhood obesity management: ambulatory assistance (individual) and educational program (in group).Method: Children and adolescents from 7 to 13 years of age were selected at random. They were divided into two groups: individually assisted or assisted in groups. An educational program about childhood obesity was created, with monthly meetings that consisted of lectures with parents participation and group work. Simultaneously, children and teenagers of the other group received individual ambulatory assistance. The program took place for six months. Body complexion, eating habits and physical activities were assessed before and after interventions.Results: The sample comprised 38 children and adolescents whose mean age was 9.9 years old. The program was more effective in increasing physical activity (p=0.003), specially walking (p = 0.003), as well as in reducing total cholesterol (p = 0.038). Reduction of body mass index, obesity index and caloric intake was similar in both groups. As for food habits, ambulatory assistance increased the intake of fruits (p = 0.033) and vegetables (p = 0.002) and reduced the amount of French fries and crisps (p = 0.041), while children participating in the program reduced the intake of soft drinks (p = 0.022), sandwiches, pizza and fast food (p = 0.006).Conclusions: Both strategies for handling childhood obesity were favorable to changes in food and physical activity habits. Group assistance was as effective as the individual assistance, consolidating as an alternative for the obesity treatment.

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The outcome of childhood obesity management depends highly upon patient compliance

Abstract: there is an urgent need for efficient strategies to improve adherence of outpatients to obesity treatment since, in terms of reduction in body mass index standard deviation score, a beneficial outcome can be achieved for compliant obese children and adolescents.

Cited by 83 publications

References 19 publications

Laparoscopic Gastric Banding Prevents Type 2 Diabetes and Arterial Hypertension and Induces Their Remission in Morbid Obesity

Laparoscopic Gastric Banding Prevents Type 2 Diabetes and Arterial Hypertension and Induces Their Remission in Morbid Obesity

The Effect of Diet or Exercise on Visceral Adipose Tissue in Overweight Youth

Atendimento ambulatorial individualizado versus programa de educação em grupo: qual oferece mais mudança de hábitos alimentares e de atividade física em crianças obesas?

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