ESPE Abstracts

Introduction: Childhood obesity is one of the most challenging contemporary public health problems. Children and adolescents with obesity experience multiple psychosocial difficulties, such as low self-esteem, depression, anxiety, and behavioral problems. Psychosocial problems noted in youngsters with excess adiposity persist for a long time. The aim of our study was to assess mental health symptoms in overweight and obese children and adolescents before and after the implementation of a personalized obesity lifestyle intervention program.

Methods: Six hundred and eleven (315 female-296 male, mean age± SD: 10.39 ± 0.10 years, 326 prepubertal-285 pubertal) children and adolescents, aged 6-18 years, were studied prospectively and classified as obese (50.2%), overweight (33.5%), and normal BMI (16.2%), according to IOTF criteria. All participants entered a 12-month lifestyle intervention program that provided personalized guidance on healthy diet and physical activity to patients and their families. A multidisciplinary team evaluated all subjects at baseline and at frequent intervals thereafter. Laboratory investigations were obtained at the beginning and the end of the study. All participants completed two psychometric questionnaires, the Children’s Depression Inventory (C.D.I) and the Screen for Child Anxiety Related Disorders (S.C.A.R.E.D), aiming to evaluate depressive and anxiety symptomatology respectively.

Results: At baseline, subjects with obesity, overweight, normal BMI and the total sample scored in the psychometric questionnaires as follows: 7.89 ± 0.33, 7.49 ± 0.39, 6.84 ± 0.56 and 7.59 ± 0.23 respectively in C.D.I, 1.65 ± 0.09, 1.59 ± 0.11, 1.49 ± 0.15 and 1.60 ± 0.06 respectively in S.C.A.R.E.D for parents and 2.14 ± 0.10, 2.05 ± 0.11, 1.97 ± 0.16 and 2.08 ± 0.07 respectively in S.C.A.R.E.D for children. After the completion of the study, a significant decrease in the score of S.C.A.R.E.D was noted in participants with obesity based on children’s opinion (P<0.001), as well as in all subjects independently of BMI based on parent’s opinion (P<0.003). Furthermore, significant reduction in C.D.I. scores (P=0.03) was recorded in participants with obesity. When subjects were categorized based on the questionnaires threshold to detect pathology, depressive symptomatology was found in 12.1% of participants and anxiety symptomatology in 35.3% based on children’s perspective and in 23.5% based on parent’s opinion. These percentages significantly decreased following the intervention (P<0.001).

Conclusion: The implementation of multidisciplinary, personalized lifestyle interventions in the management of obesity in childhood and adolescence is associated with a significant improvement of anxiety and depressive symptomatology. Further studies are required to clarify the underlying pathophysiologic mechanisms.