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Children With Morbid Obesity Benefit Equally as Children With Overweight and Obesity From an Ongoing Care Program
J M Rijks1, J Plat1, R P Mensink1
1Centre for Overweight Adolescent and Children's Healthcare, Department of Paediatrics (J.M.R., E.D.M., A.C.E.V.), Maastricht University Medical Centre, P. Debyelaan 25, 6229 HX Maastricht, The Netherlands; Department of Human Biology (J.P., R.P.M.), School of Nutrition and Translational Research in Metabolism (J.M.R., J.P., R.P.M., E.D., A.C.E.V.), Maastricht University, Universiteitssingel 6229 HR, Maastricht, The Netherlands; and Department of Neuropsychology & School for Mental Health and Neuroscience (W.A.B.), Maastricht University Medical Centre, P. Debyelaan 25, 6229 HX, Maastricht, The Netherlands.
Insights
An ongoing lifestyle intervention effectively manages morbid obesity in children, improving weight and cardiovascular health. This approach benefits children with overweight, obesity, and morbid obesity equally.
Area of Science:
- Pediatric Endocrinology
- Public Health
- Cardiovascular Health
Background:
- Childhood obesity rates are stabilizing, but severe obesity is increasing.
- Lifestyle interventions alone have limited long-term success in morbidly obese children.
- A chronic care model is essential for sustained weight management and health in pediatric obesity.
Purpose of the Study:
- To assess the impact of a continuous lifestyle intervention on children with morbid obesity.
- To compare the intervention's effectiveness in children with morbid obesity versus those with overweight and obesity.
Main Methods:
- A nonrandomized prospective intervention study was conducted.
- 172 children and adolescents (100 females, 72 males) with overweight, obesity, or morbid obesity received outpatient, tailored lifestyle intervention.
- Follow-up was conducted at 12 and 24 months, measuring Body Mass Index (BMI) z-score.
Main Results:
- In morbidly obese children, intervention led to significant decreases in BMI z-score at 12 and 24 months.
- 21-25% of morbidly obese children improved their weight status category to obese after intervention.
- Significant improvements in cardiovascular risk factors (cholesterol, HbA1c, blood pressure) were observed across all weight categories.
Conclusions:
- Children with overweight, obesity, and morbid obesity show equal benefits from ongoing lifestyle interventions.
- Tailored, outpatient interventions lead to significant weight loss and improved cardiovascular health in pediatric populations.
- A chronic care model is effective for managing pediatric obesity and associated health risks.
Context:
Despite stabilization of childhood overweight and obesity prevalence, there is a shift toward more severe degrees of obesity, which results in an increasing prevalence of children with morbid obesity. Prior studies demonstrated that lifestyle modification without ongoing treatment has only a modest and not sustainable effect in children with morbid obesity. This suggests that a chronic care model is necessary for long-term effects on weight management and health.
Objective:
This study aimed to evaluate the effect of an ongoing lifestyle intervention in children with morbid obesity in comparison with children with overweight and obesity.
Design And Setting:
This was a nonrandomized prospective intervention study with 12- and 24-month followup at the Centre for Overweight Adolescent and Children's Healthcare.
Patients And Intervention:
Children and adolescents (n = 100 females and 72 males) with overweight, obesity, or morbid obesity were given long-term, outpatient, tailored lifestyle intervention.
Main Outcome Measure:
Body mass index (BMI) z score was measured.
Results:
In children with morbid obesity, 12- and 24-month interventions resulted in a decrease of BMI z score of -0.13 ± 0.25 (P = .001) and -0.23 ± 0.32 (P = .01) respectively, whereas weight status category improved to obese in 21% and 25% of the children. Cardiovascular risk parameters including serum total cholesterol, low-density lipoprotein cholesterol, glycosylated hemoglobin (HbA1c), and diastolic blood pressure significantly improved after 1-year intervention in the complete group. Most important, BMI z score as well as cardiovascular risk parameters improved to a similar degree in children with overweight, obesity, and morbid obesity.
Conclusions:
Children with overweight, obesity, and morbid obesity benefit equally from an ongoing, outpatient, tailored lifestyle intervention, and demonstrate significant weight loss and improvement of cardiovascular risk parameters.
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