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Prädiktor für die Grundversorgung kindlicher Adipositas

Bedeutung von Motivations- und Fähigkeitsgrad bzw. psychosozialer Situation

Predictor for primary health care in pediatric obesity

Relevance of motivation, ability and psychosocial situation

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Zusammenfassung

Hintergrund

Übergewichtsbehandlungen sind im Einzelsetting kaum erfolgreich. Mit dieser Studie wurde evaluiert, ob sich Subgruppen von Patienten für eine einfache Therapie in der Praxis eignen.

Methode

71 Adipöse [BMI (Body-Mass-Index) >97. Perzentile; 12±4,5 Jahre] wurden in Gruppen (Beurteilung: 1: schlecht, bis 5: sehr gut) bezüglich Ernährung und Bewegung bzw. psychosozialer Situation eingeteilt. Der BMI wurde vor und nach einer 18-monatigen ambulanten Therapie in der Praxis gruppenabhängig verglichen.

Ergebnisse

Bezüglich Ernährung und Bewegung zeigte die Gruppeneinteilung signifikante Unterschiede (pGruppe=0,001 bzw. 0,002): Je schlechter das Verhalten, desto mehr lag der BMI über der 97. Perzentile. Außerdem bestand eine signifikant unterschiedliche Wirkung der Intervention zwischen den verschiedenen Gruppen (pGruppe×Intervention=0,006 bzw. 0,001): Die am schlechtesten Eingeschätzten verschlechterten sich, die besser Eingeschätzten besserten sich.

Schlussfolgerung

Eine einfache Einschätzung des Grundversorgers bezüglich Ernährung, Bewegung und psychosozialer Belastung erlaubt, die therapeutische Wirkung vor einer Intervention einzuschätzen. Für den Praxisalltag empfiehlt sich eine solche Differenzierung, um die Indikation zur erfolgreichen Therapie des Grundversorgers zu ergänzen und zu verbessern.

Abstract

Background

Treatment of obesity in individual settings is generally of little success. The present study evaluates whether subgroups of obese children are suited to simple general-practitioner-based therapy.

Methods

A total of 71 obese children (BMI >97th percentile; 12 ± 4.5 years) were divided into groups (scored from 1=bad to 5=very good) with regard to nutritional behaviour, physical activity as well as personal and family resources. At the beginning and end of an 18-month outpatient therapy BMI was compared within the groups.

Results

Nutritional behaviour and physical activity showed significant group differences (pgroup=0.001 resp. 0.002): the poorer the motivation and ability, the higher the BMI above the 97th percentile. Moreover, there was a significant difference in effect between the varying groups (pgroup x intervention=0.006 resp. 0.001): those patients with the lowest ratings worsened further, whereas the better-scoring patients improved.

Conclusion

A simple tool to assess nutritional, physical activity and psychosocial situation by medical practitioners may predict whether patients are responders or non-responders to treatment. This may improve and strengthen the efficiency of medical practitioners by selecting potentially successful patients in advance.

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Authors and Affiliations

  1. Praxis Ferrazzini, Zürich, Schweiz

    G. Ferrazzini

  2. Alpine Kinderklinik Davos, Scalettastraße 3, CH-7270, Davos Platz, Schweiz

    M. Lehmann &  B. Knöpfli

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  1. G. Ferrazzini
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  2. M. Lehmann
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  3. B. Knöpfli
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Correspondence to B. Knöpfli.

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Ferrazzini, G., Lehmann, M. & Knöpfli, B. Prädiktor für die Grundversorgung kindlicher Adipositas. Monatsschr Kinderheilkd 158, 48–53 (2010). https://doi.org/10.1007/s00112-009-2024-8

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