ESPE Abstracts

Background: It has been discussed in literature, that being severely obese and adolescent are predictive for failure in a behavior based weight-loss program.

Objective: To investigate the association between age and initial BMI-SDS with BMI-SDS courses during and after the attendance of an inpatient weight-loss program.

Design: The LOGIC-trial involves overweight and obese children and adolescents (6–19 years), who participate in an inpatient weight-loss program for 4–6 weeks. Height and weight values were taken at the start (T₀), at the end of the intervention (T₁) and one year after start of the intervention (T₂). The study sample includes n=1.046 participants (T₀). The recall rate at T₂ was relatively high (54.6% of the original cohort). Missing BMI values were replaced by baseline observation carried forward method. Age at baseline (years) was grouped: 7–11 (n=214); 12–14 (n=501); ≧15 (n=331). BMI-SDS values at baseline were grouped by using the 75^th internal percentile (low vs. high). Linear mixed effects model (piecewise linear function with a knot at T₁) was calculated.

Results: BMI-SDS courses are significantly determined by age and BMI-SDS at baseline. Older children (≧15 yrs) improved the least in reducing BMI-SDS under short-term intervention compared to the younger participants (independent of BMI-SDS at baseline). During 1-year follow-up BMI-SDS increased in all participants. The strongest increase was observed in 12–14 year-old children with a high BMI-SDS at baseline. 12–14 years old children showed the smallest BMI-SDS reduction during FU compared to the younger and older age groups, independent of BMI-SDS at baseline. The BMI-SDS difference (T₀–T₂) was −0.15 in children (12–14 years) with a low BMI-SDS and −0.05 in children with a high BMI-SDS at baseline.

Conclusion: Age and BMI-SDS at baseline determine the BMI-SDS courses during and after the attendance of an inpatient weight-loss program. The long-term success of an inpatient weight-loss program was lowest in 12–14 years old children.

Funding: The LOGIC-study is funded by the non-profit organization Else Kröner-Fresenius-Stiftung, Bad Homburg, Germany and the German statutory pension insurance scheme, Landshut, Germany.