Evaluating the long-term effectiveness of a structured telehealth obesity program in children and adolescents: A
Nora Struckmeyer1,2, Torben Biester1, Chantal Weiner1
1Children's Hospital AUF DER BULT, Hanover, Germany.
Insights
Telehealth interventions effectively manage pediatric obesity, showing sustained BMI SDS reductions and improved quality of life. This approach is safe, effective, and sustainable for long-term childhood obesity care.
Area of Science:
- Pediatric Endocrinology
- Public Health
- Digital Health
Background:
- Childhood obesity is a significant global health challenge exacerbated by lifestyle factors and the COVID-19 pandemic.
- Impaired health-related quality of life (HrQoL) is a common consequence of pediatric obesity.
- Telehealth presents a scalable solution for delivering comprehensive pediatric obesity management.
Purpose of the Study:
- To evaluate the long-term effectiveness of a structured pediatric telehealth intervention for obesity.
- To compare telehealth outcomes with historical in-person treatment data.
- To assess the impact of telehealth on various clinical and quality-of-life metrics.
Main Methods:
- Retrospective cohort study of 237 children and adolescents with obesity.
- Comparison between a telehealth group (n=117) and a historical in-person group (n=120).
- Assessment of BMI standard deviation score (SDS), physical fitness, insulin resistance, dietary behavior, eating regulation, and HrQoL over 12-36 months.
Main Results:
- Both groups showed significant BMI SDS reduction at 12 months; telehealth group sustained improvements up to 36 months.
- Telehealth participants demonstrated greater improvements in diet, appetite regulation, and HrQoL (emotional, family domains).
- Improvements were observed in physical performance and insulin resistance (HOMA index) in both cohorts; no adverse events reported.
Conclusions:
- Structured telehealth interventions are safe, effective, and sustainable for pediatric obesity management.
- Telehealth is a clinically viable model for improving weight status and quality of life in children with obesity.
- Both weight reduction and stabilization through telehealth contribute to positive long-term health outcomes.
Background:
Childhood obesity is a growing global health crisis, driven by poor diet, reduced physical activity, and psychosocial distress. The COVID-19 pandemic amplified these factors, contributing to rising BMI and impaired health-related quality of life (HrQoL). Telehealth offers a promising, scalable modality to deliver multimodal obesity care. This study evaluated the long-term effectiveness of a structured pediatric telehealth intervention compared to historical in-person treatment.
Methods:
This retrospective cohort study analyzed data from 237 children and adolescents with obesity treated at a single academic center. Between 2020 and 2022, 117 participants received a 12-month structured lifestyle intervention via telehealth. A historical cohort (n = 120; 2017-2019) received the same intervention in person. Clinical outcomes were assessed at baseline and after 12 months; the telehealth group was additionally followed up at 24 and 36 months. Primary outcome was change in BMI standard deviation score (BMI SDS). Secondary outcomes included physical fitness (6-min walk test), insulin resistance (HOMA index), lipid profile, dietary behavior (K-FFL), eating regulation (K-FEV), and HrQoL (KINDL-R).
Results:
Both groups achieved significant reductions in BMI SDS after 12 months, with sustained improvements in the telehealth group through 36 months (Δ = -0.18; p < 0.05). Physical performance and HOMA index improved in both cohorts. Telehealth participants showed greater improvements in healthy dietary behavior, cognitive appetite regulation, and Health-related quality of life HrQoL, especially in emotional and family domains. No adverse events occurred; adherence exceeded 85 %.
Conclusion:
A structured telehealth lifestyle intervention is safe, effective, and sustainable for pediatric obesity management. These findings support telehealth as a clinically viable and sustainable model for pediatric obesity care, recognizing that both weight reduction and weight stabilization may contribute to improved long-term outcomes.
