The majority of treated obese children fail the goals set in the medium-long term or do not show themselves up at the short term follow up. These results, which do not improve even with the proliferation of facilities aimed to the treatment of obesity and of its complications, pose serious questions on how to make the best use of scarce resources available by the National health system. We have visited, between 2013 and 2015, 378 seriously obese children (>2 DS from national BMI curves of the Italian Society of Pediatric Endocrinology and Diabetology) 215 males and 163 females, aged 614 years, in the years 20132015. We calculated the BMI of their parents and we split the patients into two groups: group A, in which we included those whose parents sum of BMI-SDS overcame 4; group B, the remaining patients. We evaluated how many in each group were still in follow-up at six and twelve months, and those who had achieved and maintained a reduction of at least 1 BMI-SDS twenty-four months after the first logon. In Group A 90.2% were lost to follow up in 6 months, and the remaining 80.1 was absent at 12 months; whereas in Group B this percentage was respectively 78.4 (P<0.05) and 43.7 (P<0.05). At 24 months, 29.5% of children still followed in group A had achieved the result of reducing and maintaining at least 1 DS their own BMI vs 38.3 in Group B (P<0.05). These results have suggested us that parental obesity may influence the adherence to lifestyle modification proposals (slightly hypocaloric diet, increased physical activity, practical advice on how to eat and how to do physical activity). On the basis of these findings, despite being surely influenced by the limited means our Center could dispose of, and also because of this, we decided to send to the follow up, after the first visit, only those whose parents, according to the history and the sum of its BMI-SDS, were likely to become less obesogenic (cut-off 4 BMI-SDS), and to send everyone else again to the family doctor. With this selection, we believe we can provide a more adequate support to those who could most potentially promise better results; in this way we believe we employ at best the human and economic resources the Local Health Authority makes available for the treatment of childhood obesity.
27 - 29 Sep 2018
European Society for Paediatric Endocrinology