ESPE Abstracts

Background: Obesity in adolescence is associated with a 70% likelihood of obesity or overweight in adulthood. Hence, effective intervention programs for childhood obesity in high-risk populations are needed.

Objectives: i) To compare the efficacy of two intervention strategies, involving parents only vs parent and child, to a control group, in the treatment of childhood obesity. ii) To identify clinical demographical and biochemical predictors for decreased BMI-SDS.

Methods: 247 children with BMI: 85–99 percentile, 5–11 years, were recruited to the study. The participants were randomized into three groups: parents only (n=84) or parents and child group (n=89), who participated in 12-week meetings with a dietician and a psychologist, and a control group (n=74). Follow-up continued for 2 years. Changes in anthropometric and clinical outcome were assessed.

Results: 46 (52%), 45 (54%), 37 (50%), in the parents only, parents and the control groups respectively, had completed 2 years follow-up. At 12 weeks, the decrease in BMI-SDS was significant only in the intervention groups, and decreased from 1.74±0.31 to 1.66±0.36 in the parents’ group (P<0.001), and from 1.83±0.33 to 1.76±0.36 in the parents and child group (P=0.012), with no significant change in the control group (1.73±0.32 to 1.70±0.31, P=0.301). After 2-years, decrease in BMI-SDS was significant only in the parents and child group (BMI-SDS after two-years follow up: 1.56±0.46, P=0.006). According to a stepwise linear regression analysis, older age (β=0.282, P=0.012), lower baseline TSH levels (β=−0.214, P=0.049) and higher adiponectin levels at the end of the intervention (β=0.345, P=0.002), were associated to greater decline in BMI-SDS during the intervention.

Conclusions: A behavioural intervention program for the prevention and treatment of childhood obesity that focuses on parents and children was found to have significant positive short and long term effects on BMI-SDS. Lower baseline TSH levels might predict better short-term outcomes.

Funding: Grant from the Institute of research, Clalit Health Services.