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Effects of a weight management program on body composition and metabolic parameters in overweight children: a
Mary Savoye1, Melissa Shaw, James Dziura
1Yale Center for Clinical Investigation, Yale University School of Medicine, New Haven, CT 06520, USA. mary.savoye@yale.edu
Insights
The Bright Bodies program effectively reduced adiposity and improved insulin resistance in overweight children for up to 12 months. This family-based intervention offers a sustainable solution for pediatric obesity and its associated metabolic complications.
Area of Science:
- Pediatric Endocrinology
- Obesity Medicine
- Metabolic Health
Background:
- Pediatric obesity is a growing epidemic, increasing the risk of type 2 diabetes and long-term metabolic complications.
- Overweight children often become overweight adults, necessitating early and effective interventions.
- Type 2 diabetes in youth is a significant public health concern linked to childhood obesity.
Purpose of the Study:
- To evaluate the efficacy of the Bright Bodies family-based weight management program.
- To compare the effects of the intervention on adiposity and insulin resistance in overweight children versus a control group.
- To assess the sustainability of treatment effects over a 12-month period.
Main Methods:
- A 1-year randomized controlled trial involving 209 overweight children (ages 8-16).
- Participants were assigned to either a control group (traditional counseling) or an intensive family-based weight management program.
- Primary outcomes included changes in weight, BMI, body fat, and HOMA-IR at 6 and 12 months.
Main Results:
- The weight management group showed significant improvements in weight, BMI, body fat, and HOMA-IR at 6 months, which were sustained at 12 months.
- In contrast, the control group experienced increases in weight, BMI, and body fat over the study period.
- Improvements in homeostasis model assessment of insulin resistance (HOMA-IR) were observed in the intervention group compared to the control group.
Conclusions:
- The Bright Bodies program demonstrated significant and sustained benefits for body composition and insulin resistance in overweight children.
- Family-based, intensive interventions are effective in managing pediatric obesity and mitigating metabolic risks.
- The findings support the Bright Bodies program as a viable strategy for addressing childhood obesity and preventing long-term health issues.
Context:
Pediatric obesity has escalated to epidemic proportions, leading to an array of comorbidities, including type 2 diabetes in youth. Since most overweight children become overweight adults, this chronic condition results in serious metabolic complications by early adulthood. To curtail this major health issue, effective pediatric interventions are essential.
Objective:
To compare effects of a weight management program, Bright Bodies, on adiposity and metabolic complications of overweight children with a control group.
Design:
One-year randomized controlled trial conducted May 2002-September 2005.
Setting:
Recruitment and follow-up conducted at Yale Pediatric Obesity Clinic in New Haven, Conn, and intervention at nearby school.
Participants:
Random sample of 209 overweight children (body mass index [BMI] >95th percentile for age and sex), ages 8 to 16 years of mixed ethnic groups were recruited. A total of 135 participants (60%) completed 6 months of study, 119 (53%) completed 12 months.
Intervention:
Participants were randomly assigned to either a control or weight management group. The control group (n = 69) received traditional clinical weight management counseling every 6 months, and the weight management group (n = 105) received an intensive family-based program including exercise, nutrition, and behavior modification. Intervention occurred biweekly the first 6 months, bimonthly thereafter. The second randomization within the weight management group assigned participants (n = 35) to a structured meal plan approach (dieting), but this arm of the study was discontinued while enrollment was ongoing due to a high dropout rate.
Main Outcome Measures:
Change in weight, BMI, body fat, and homeostasis model assessment of insulin resistance (HOMA-IR) at 6 and 12 months.
Results:
Six-month improvements were sustained at 12 months in weight management vs control, including changes in the following (mean [95% confidence interval]): weight (+0.3 kg [-1.4 to 2.0] vs +7.7 kg [5.3 to 10.0]); BMI (-1.7 [-2.3 to -1.1] vs +1.6 [0.8 to 2.3]); body fat (-3.7 kg [-5.4 to -2.1] vs +5.5 kg [3.2 to 7.8]); and HOMA-IR (-1.52 [-1.93 to -1.01] vs +0.90 [-0.07 to 2.05]).
Conclusion:
The Bright Bodies weight management program had beneficial effects on body composition and insulin resistance in overweight children that were sustained up to 12 months.
Trial Registration:
clinicaltrials.gov Identifier: NCT00409422.
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