[Multidisciplinary treatment of pediatric obesity. Results in 213 patients]

The objective of this study was to evaluate the results that have been obtained on obese patients with different modalities of treatment.

Two hundred thirteen patients (118 girls and 95 boys) diagnosed with exogenous obesity with an average age of 10.3 +/- 2.4 years (range 5-14 years) have been studied. The patients were classified into four different groups depending on the type of health specialty by which they were treated: a) Nutritionist; b) Nutritionist and dietician; c) Nutritionist and paidopsychiatry and d) Nutritionist, dietician and paidopsychiatry. The duration of the treatment was 1.0 +/- 0.8 years (0.1-4.6 years).

Seventy-five patients (35%) abandoned treatment. A decrease of the body mass index > 2 points/year, criterion to be considered as a good response, was accomplished in 78 patients (36.6%). A good response associated with the fulfillment of the diet showed a sensitivity of 86% and a specificity of 62%. The increase of the size between the first and the last check-up was remarkably inferior in those patients who fulfilled the diet in relationship to those who did not (p < 0.003) and in the patients who had good response in relation to the patients who did not (p < 0.03). The control of the patients by different specialists did not improve the response, although there is a tendency for a better response in the patients of group-d with regards to the total of patients in the rest of the groups (41.3% vs 31.8%). A lower number of patients treated by a dietician left the treatment and 73% of these lost weight at some time during the treatment.

Good response to the treatment seems to be associated with the fulfillment of the diet strictly controlled by the dietician, as well as with physical exercise. The lower increase of the height in patients with good fulfillment of the diet shows the necessity of a strict control of these patients.