Background: Lifestyle interventions show a long lasting weight reduction in only 1020% of obese children and adolescents. Leptin as one major player within the central regulation of food intake and energy expenditure is most likely to mediate the endogenous drive for weight regain.
Objective and hypotheses: To estimate weight regain after weight loss and the role of leptin in regain.
Method: We included 153 obese children/adolescents (14±1.9 years; 53% female; BMI 31±4.0 kg/m2) into a multiprofessional lifestyle intervention program. After 3 months weight loss (timepoint T3 to T0) 137 children who lost at least −0.2 BMISDS were randomized (T0) into a control group (n=71) without further intervention and into a life style intervention group (n=64). After 12 months (T12; n=126) and 18 months (T18; n=109) the study cohort was re-evaluated.
Results: At T12 and T18, the BMISDS is significantly higher in the control group in relation to the intervention group (T12: 2.40 vs 2.20, P=0.003; and T18: 2.46 vs 2.30, P=0.045), demonstrating the positive effect of further intervention on weight maintenance. Leptin is significantly correlated to BMISDS (r>0.45; P<0.001) and even stronger to % body fat (r>0.59; P<0.001) at all study dates and furthermore Leptin at T0 to BMISDS (r=0.43; P<0.001) and % body fat (r=0.63; P<0.001) at T18.
Conclusion: Although weight regain in obese children and adolescents is partly preventable with further lifestyle intervention the majority of patients show significant weight regain within 18 months. Leptin levels were shown to play an only marginal role in the endogenous regulation of weight regain. Therefore the molecular basis of weight regain still need to be determined.
20 - 22 Sep 2014
European Society for Paediatric Endocrinology