ESPE Abstracts (2016) 86 P-P2-506

Long Term Outcomes after Hospital Based, Life-Style Weight Loss Intervention During Childhood

Toby Candlera, Christina Weia,b, Elizabeth Crownea & Julian Shielda,c

aBristol Royal Hospital for Children, Bristol, UK; bSt George’s Hospital, London, UK; cNIHR Bristol Biomedical Research Unit in Nutrition, University of Bristol, Bristol, UK

Background: Weight loss interventions for obesity have shown variable short-term effects in adolescents and children, but data on longer-term benefits are sparse.

Aim: To describe longer-term impact of lifestyle weight loss interventions in adolescent obesity.

Method: Obese subjects previously underwent lifestyle weight loss interventions at a hospital-based clinic were invited to participate in metabolic re-assessment. Outcome measures included: blood pressure (BP), BMI-Z, lipid profile, alanine aminotransferase (ALT), fat% from bioimpedance and oral glucose tolerance tests (OGTT). Data were compared by Mann-Whitney U tests at 5% significance and reported in median (ranges).

Results: 25 (M=10) subjects were recruited. Median age was 14.1 (9.5–17.6) years at the beginning of intervention and 18.2 (16.1–24.8) years at re-assessment. With lifestyle interventions, after 3.5 (1.4–14.1) years, 28% (7/25) had BMI-Z reduction of >0.25 from baseline (responders). Responders demonstrated significant reduction in BMI-Z (2.98 vs 3.36, P=0.017), total fat% (35.1 vs 46.2, P=0.003), systolic BP (115 vs 136 mmHg, P=0.007) and glucose area-under-the-curve from OGTT (11.7 vs 15.2, P=008) at re-assessment compared with baseline. Non-responders showed significant increases in total fat% (47.2 vs 40.2, P=0.03) and trunk fat % (44.9 vs 33.7, P=0.03). At re-assessment, responders compared with non-responders showed significant differences in BMI-Z changes (−0.4 vs 0.36, P=0.034), BMI-Z (2.98 vs 3.34, P=0.034), total fat% (35.1 vs 47.2, P=0.001), trunk fat % (34.2 vs 44.9, P=0.005), 120 min insulin from OGTT (16.3 vs 92.4 mU/l, P=0.029), ALT (26 vs 34 U/l, P=0.041), and better insulin sensitivity (ISIcomp: 3.81 vs 1.73, P=0.021). There were no differences in diastolic BP or lipid profile.

Conclusion: These data suggest that slightly >1/4 obese adolescents benefit in the longer term after lifestyle modification interventions with associated improvements in body composition and metabolic parameters in young adulthood. Whilst, by no means ubiquitous in effect, a simple intervention that improves the anthropometrics and metabolic health in the longer-term of one in four obese adolescents undergoing therapy is encouraging given the pandemic of adult obesity.

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