“…Individual treatment response is an important outcome measure, in addition to mean changes. 43 , 44 A previous study found that half of children improved their anthropometric status, despite no mean group change in BMI SDS. 44 Currently, there is no consensus on thresholds that indicate clinically meaningful changes in BMI SDS among children and adolescents.…”
Section: Discussionmentioning
confidence: 98%
“…In the present study, significantly more participants in the FBSFT group achieved a BMI SDS reduction of ≥0.25 (31.5% in FBSFT group compared to 13% in TAU group). Individual treatment response is an important outcome measure, in addition to mean changes 43,44 . A previous study found that half of children improved their anthropometric status, despite no mean group change in BMI SDS 44 .…”
Section: Discussionmentioning
confidence: 99%
“…Suggested reductions in BMI SDS required to improve metabolic health range from 0.1 to 0.5. 26 , 27 , 45 In general, it appears that a reduction in BMI SDS of ≥0.25 is required for clinical effectiveness, 26 , 43 , 44 and larger benefits can be expected with reductions of ≥0.50. 44 However, another Norwegian study found that even small or modest BMI SDS reductions from ≥0.00 to <0.10 were associated with an improvement in several cardiovascular risk factors.…”
To compare the effectiveness of family-based behavioural social facilitation treatment (FBSFT) versus treatment as usual (TAU) in children with severe obesity. Parallel-design, nonblinded, randomized controlled trial conducted at a Norwegian obesity outpatient clinic. Children aged 6-18 years referred to the clinic between 2014 and 2018 were invited to participate. Participants were randomly allocated using sequentially numbered, opaqued, sealed envelopes. FBSFT (n = 59) entailed 17 sessions of structured cognitive behavioural treatment, TAU (n = 55) entailed standard lifestyle counselling sessions every third month for 1 year. Primary outcomes included changes in body mass index standard deviation score (BMI SDS) and percentage above the International Obesity Task Force cut-off for overweight (%IOTF-25). Secondary outcomes included changes in sleep, physical activity, andeating behaviour. From pre-to posttreatment there was a statistically significant difference in change in both BMI SDS (0.19 units, 95% confidence interval [CI]: 0.10-0.28, p < .001) and p < .001) between FBSFT and TAU groups. FBSFT participants achieved significant reductions in mean BMI SDS (0.16 units, (95%CI: À0.22 to À0.10, p < .001) and %IOTF-25 (6.53%, 95% CI: À8.45 to À4.60, p < .001), whereas in TAU nonsignificant changes were observed in BMI SDS (0.03 units, 95% CI: À0.03 to 0.09, p = .30) and %IOTF-25 (À1.04%, 95% CI: À2.99 to À0.90, p = .29). More FBSFT participants (31.5%) had clinically meaningful BMI SDS reductions of ≥0.25 from pre-to posttreatment than in TAU (13.0%, p = .021). Regarding secondary outcomes, only changes in sleep timing differed significantly between groups. FBSFT improved weight-related outcomes compared to TAU. Yngvild S. Danielsen and Petur B. Juliusson are joint senior authors.
“…Individual treatment response is an important outcome measure, in addition to mean changes. 43 , 44 A previous study found that half of children improved their anthropometric status, despite no mean group change in BMI SDS. 44 Currently, there is no consensus on thresholds that indicate clinically meaningful changes in BMI SDS among children and adolescents.…”
Section: Discussionmentioning
confidence: 98%
“…In the present study, significantly more participants in the FBSFT group achieved a BMI SDS reduction of ≥0.25 (31.5% in FBSFT group compared to 13% in TAU group). Individual treatment response is an important outcome measure, in addition to mean changes 43,44 . A previous study found that half of children improved their anthropometric status, despite no mean group change in BMI SDS 44 .…”
Section: Discussionmentioning
confidence: 99%
“…Suggested reductions in BMI SDS required to improve metabolic health range from 0.1 to 0.5. 26 , 27 , 45 In general, it appears that a reduction in BMI SDS of ≥0.25 is required for clinical effectiveness, 26 , 43 , 44 and larger benefits can be expected with reductions of ≥0.50. 44 However, another Norwegian study found that even small or modest BMI SDS reductions from ≥0.00 to <0.10 were associated with an improvement in several cardiovascular risk factors.…”
To compare the effectiveness of family-based behavioural social facilitation treatment (FBSFT) versus treatment as usual (TAU) in children with severe obesity. Parallel-design, nonblinded, randomized controlled trial conducted at a Norwegian obesity outpatient clinic. Children aged 6-18 years referred to the clinic between 2014 and 2018 were invited to participate. Participants were randomly allocated using sequentially numbered, opaqued, sealed envelopes. FBSFT (n = 59) entailed 17 sessions of structured cognitive behavioural treatment, TAU (n = 55) entailed standard lifestyle counselling sessions every third month for 1 year. Primary outcomes included changes in body mass index standard deviation score (BMI SDS) and percentage above the International Obesity Task Force cut-off for overweight (%IOTF-25). Secondary outcomes included changes in sleep, physical activity, andeating behaviour. From pre-to posttreatment there was a statistically significant difference in change in both BMI SDS (0.19 units, 95% confidence interval [CI]: 0.10-0.28, p < .001) and p < .001) between FBSFT and TAU groups. FBSFT participants achieved significant reductions in mean BMI SDS (0.16 units, (95%CI: À0.22 to À0.10, p < .001) and %IOTF-25 (6.53%, 95% CI: À8.45 to À4.60, p < .001), whereas in TAU nonsignificant changes were observed in BMI SDS (0.03 units, 95% CI: À0.03 to 0.09, p = .30) and %IOTF-25 (À1.04%, 95% CI: À2.99 to À0.90, p = .29). More FBSFT participants (31.5%) had clinically meaningful BMI SDS reductions of ≥0.25 from pre-to posttreatment than in TAU (13.0%, p = .021). Regarding secondary outcomes, only changes in sleep timing differed significantly between groups. FBSFT improved weight-related outcomes compared to TAU. Yngvild S. Danielsen and Petur B. Juliusson are joint senior authors.
“…A higher body mass index standard deviation score at baseline, good motivation and adherence contributed to favourable outcomes, while acanthosis nigricans, which is a skin condition associated with insulin resistance, was associated with a poor outcome. Dubnov‐Raz and Berry comment on the findings . …”
Section: What Makes Paediatric Obesity Treatment Successful?mentioning
Probiotics may prevent necrotising enterocolitis in preterm infantsThis systematic review and meta-analysis by Thomas et al. (1) demonstrates that providing very low-birthweight infants with probiotic supplements led to significant reductions in the incidence of necrotising enterocolitis and all-cause mortality. Probiotic formulations containing the Bifidobacterium and Lactobacillus species were found to be the most efficacious. Abrahamsson comments on the findings (2). Readers may also be interested in the paper by Strunk et al. (3) who found that antimicrobial protein and peptide levels were not altered in very preterm infants by Bifidobacterium breve supplements. The findings are discussed in the accompanying editorial by Popescu et al. (4).
“…The distribution of continuous variables was evaluated using histograms and Q-Q plots and is presented as the mean ± standard deviation for the reader's ease. Individual zBMI changes in both study groups are also presented [20]. Baseline characteristics and pre-post changes were compared between groups, using the Mann-Whitey U test, t-test, and chi square test, as applicable.…”
The recommended treatment for children with obesity includes numerous consultations by a multidisciplinary team, which is very cumbersome. Telehealth can assist in administering frequent care to children with obesity, yet the exact approaches and modes of delivery are still explored. During the COVID-19 pandemic, we developed an intensive telehealth-based treatment program that included a rewarding app for children with obesity. The aim of this study was to compare 6-month changes in body mass index (BMI) and body fat percent between participants in the program (n = 70) vs. children that underwent historic on-site care (n = 87). After 6 months, more participants in the telehealth group continued treatment compared to the on-site group (79% vs. 60%, p < 0.001). A significant reduction in the median BMI z-score (zBMI) was seen after 6 months in both groups (p < 0.01), with a similar proportion of zBMI reductions (71% in the telehealth group, 75% in the comparison group, p = 0.76). No statistically significant differences were found between the study groups in 6-month changes in BMI, zBMI, body fat percent or fat z-scores. We conclude that our telehealth program, which was executed during the COVID pandemic, resulted in a high proportion of children with zBMI reduction that was comparable with the more personal on-site care.
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