Background: Despite the lack of drugs, conservative management of childhood obesity allows for considerable weight reduction.
Objective and hypotheses: i) To evaluate anthropometric and metabolic changes in obese children after intense weight loss. ii) To analyze the influence of the amount of weight loss and the time spent to attain it on the observed changes. iii) To investigate BMI evolution during the first 3 years after weight reduction.
Method: Out of 1300 obese children/adolescents evaluated, a prospective study was conducted in 132 (11.28±2.83 years; 3.99±1.93 BMISDS; 62.1% males; and 47.7% prepubertal) who reduced their BMI more than 1.5 SDS (52.1%) and/or their weight over 10% (47.9%). Studied variables: glycaemia, insulin, HOMA, HbA1c, uric acid, lipid profile, and nutritional markers (25-OH-vitamin-D, proteins, albumin, and ferritin); raw weight difference and time gap from baseline (B) to weight reduction; BMISDS at 6 months and yearly up to 3 years after weight reduction.
Results: Mean time to weight reduction was 0.79±0.60 years (35%, <6 months and 80.2%, <1 year), resulting in an increase in HDL and a decrease in the remaining parameters of the lipid profile, glycemia, insulin, HOMA (all P<0.01), with no nutritional impairment. No correlations were found between the magnitude in metabolic changes, the amount of weight lost, nor the time from baseline to weight reduction. Mean BMISDS remained unchanged during the first year after weight reduction (at baseline: 3.99±1.93 and at weight reduction: 2.69±1.21; 6 months after weight reduction: 2.35±1.29 (n=114) and 1 year after weight reduction: 2.67±1.69 (n=72)), with a partial regain during the second year (3.11±1.74 BMISDS (n=41)) and sustained BMI in the third year (3.16±2.51 BMISDS (n=31)).
Conclusions: i) Conservative treatment allows for considerable BMI reduction in around 10% obese children/adolescents, resulting in metabolic improvement without impairment of nutritional status, independently of the time spent to achieve weight loss. ii) Attained weight loss can be sustained up to 3 years after its achievement.
Funding: This work was supported by the CIBER Fisiopatología de la Obesidad y Nutrición (CB06/03) and the Instituto de Salud Carlos III, Fondo de Investigación Sanitaria (FIS: grant numbers PI10/00747 and PI13/02195).
01 - 03 Oct 2015
European Society for Paediatric Endocrinology