ESPE Abstracts

Introduction: Childhood obesity has reached epidemic proportions in contemporary societies with multiple comorbidities. Social stigma, low self-esteem, depression, anxiety, and behavioral problems are noted in youth with excess adiposity, and may persist for a long time. The aim of our study was to assess the alterations in cardiometabolic risk factors and mental health in children and adolescents with excess adiposity following the implementation of a multidisciplinary, personalized lifestyle intervention program.

Methods: Five hundred and thirty-seven children and adolescents (Mean Age ± SE: 10.15 ± 0.11 years, Females 52.9%, Pubertal: 43.6%), who attended our Center for the Prevention and Management of Overweight and Obesity in Childhood and Adolescence, were recruited to participate prospectively in a twelve-month personalized lifestyle intervention program. Participants were classified as having Obesity (44.1%), Overweight (33.9%) or Normal BMI (22%) according to the IOTF criteria and were evaluated by a multidisciplinary team at frequent intervals that provided guidance on nutrition, sleep and exercise. Both at the beginning and the end of the study detailed hematologic, biochemical, and endocrinologic investigations were performed and two psychometric questionnaires were completed, the Child Behavior Checklist (CBCL) and the Youth Self Report (YSR), which evaluate multiple aspects of participants΄ psychosocial health in accordance with DSM-V categorizations.

Results: At baseline, participants with overweight and obesity had increased cardiometabolic risk compared to those with normal BMI, as well as increased internalizing (40.5%) and total problem (37.5%) scores in CBCL. Following the implementation of the 12-month lifestyle intervention program, there was a significant decrease in adiposity (BMI, BMI z-score, Waist to Height Ratio) and an improvement in cardiometabolic and glucose metabolism parameters (Blood Pressure, HDL, LDL, HbA1C, Uric Acid, fT4, T3). In addition, participants with obesity demonstrated a significant decrease in internalizing and total problem scores in both CBCL and YSR, in externalizing scores in CBCL, and in multiple shorter scales’ scores of both questionnaires compared to their normal BMI counterparts (P <0.05).

Conclusion: The implementation of a lifestyle intervention program in the management of childhood obesity is extremely important to ensure physical and mental health and prevent emotional disorders. The improvement in mental health is likely to be mediated by an improvement in energy metabolism with subsequent improvement in neuroinflammation following to changes in diet, sleep, and physical activity. Further studies are required to delineate the underlying pathophysiologic mechanisms.