Weight loss and growth velocity in obese children after very low calorie diet, exercise, and behavior modification

Abstract

The prevalence of obesity in American youth is increasing and treatment of the condition is difficult. We have developed a multi‐disciplinary weight reduction program that extends over 1 y and includes a very low‐calorie diet (VLCD) followed by a hypocaloric diet, exercise, and behavior modification. Based on data collected at baseline, at the end of the acute intervention phase (10–20 wk), and at 1‐y evaluation, we assessed the efficacy of this outpatient weight reduction program in treating obese children and adolescents in a follow‐up of a series of cases. Furthermore, we examined the impact of the approach on growth velocity and maintenance of weight loss at 1 y. Fifty‐six overweight children (aged 7–17 y) were recruited during a period of 18 mo to participate in the weight management program; 52 (93%) completed the acute phase of treatment and 35 (62.5%) successfully completed the I‐y program. There was a significant decrease in body weight and body fat, as assessed by weight determinations and skinfold measurements 0, < 0.0001; results not corrected for age). The body mass index for the 35 individuals who completed the 1‐y program decreased significantly from 32.7 on entry to 28.72 at 1 y (p < 0.0001; results not corrected for age). Conclusion: We conclude that a multidisciplinary weight reduction program that combines a VLCD, followed by a balanced hypocaloric diet, with a moderate‐intensity progressive exercise program and behavior modification is an effective means for weight reduction in obese children and adolescents.

Weight loss and the Effect on Stature in Children During a Residential Intervention Program

“…The growth acceleration during the stay with the large weight loss was not expected. Some, mainly older studies, have reported a reduction in height velocity for children on weight‐reducing diets (38,39,40,41) while other results suggest that energy restrictions do not cause any negative effects on height as indicated in this study (19,27,29,30,42,43,44). A positive effect of weight reduction on height as observed in this study is rarely reported.…”

Attrition in paediatric weight management: a review of the literature and new directions

“…This intensive programme featured medical supervision, medical nutrition therapy (hypocaloric diets), nutrition education, exercise therapy, activity education and behaviour modification. Earlier reports of this programme's success, carried out as an interventional study, had 100% of families participating in 10‐week and in 1‐year evaluations (31); subsequent reports stated that 33% of participants dropped out (most between 6 and 9 months) (32). There were no indicators of why these different outcomes were found; no analyses of differences between dropouts and completers were included.…”

Management of Obesity and Its Complications in Children and Adolescents

“…A few pilot studies have used protein-sparing modified fast, wherein carbohydrates are severely restricted but proteins are spared. It induces intense lipolysis and ketosis and hence, are not generally used in clinical practice in children and adolescents [29]. Physical activity is made more regular and tracked using logs or activity trackers.…”