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Sustainable weight loss over three years in children with obesity: a pragmatic family-centered lifestyle intervention

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Abstract

Introduction

Childhood obesity has psychological consequences and increases the risk of continuous obesity into adulthood, associated with development of non-communicable disease (e.g. type 2 diabetes). Short-term weight loss intervention studies show good results but long-term studies are limited.

Methods

One hundred ninety-nine obese children (4–18 years of age), with a BMI-SDS (standard deviation score) above + 2 SDS were enrolled into a multifactorial family-centered lifestyle intervention study. The children had yearly visits in the outpatient clinic for anthropometrics, blood samples and DXA-scans, and 6–8 meeting with community health workers between these visits. The children followed the intervention up to 3 years.

Results

After a follow-up of 26.7 ± 17.5 months a reduction in BMI-SDS of − 0.25 SDS (p < 0.001) was observed. The 57 children who were adherent to the intervention for ≥ 2 years had significantly reduced BMI-SDS compared to the 142 children with shorter intervention (BMI-SDS: − 0.38 ± 0.67 vs. − 0.20 ± 0.50, p = 0.036). All weight loss was accompanied by decrease in fat mass and increase in muscle mass (p < 0.001).

Conclusion

The intervention was found to induce long-term reduction in BMI-SDS in obese children, with beneficial change in body composition. Children who followed the intervention the longest had the greatest reduction in BMI-SDS.

Level of evidence

Level III, longitudinal cohort study.

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Abbreviations

BMI:

Body mass index

CVD:

Cardiovascular disease

T2D:

Type 2 diabetes

SDS:

Standard deviation score

TCOCT:

The Children’s Obesity Clinic’s Treatment

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Acknowledgements

Niels Henrik Bruun, statistician at the Dept. of Public Health, Aarhus University assisted with the production of graphs for the paper. Healthcare workers in the four municipalities were responsible for measuring anthropometrics between hospital visits.

Funding

The study did not receive any funding.

Author information

Authors and Affiliations

  1. Department of Pediatrics, Randers Regional Hospital, Skovlyvej 15, 8930, Randers NE, Denmark

    Rasmus Møller Jørgensen, Britta Kremke, Rikke Frederiksen Bahnsen, Bent Windelborg Nielsen & Esben Thyssen Vestergaard

  2. Department of Internal Medicine, Randers Regional Hospital, Randers NE, Denmark

    Jens Meldgaard Bruun

  3. Steno Diabetes Center Aarhus, Aarhus, Denmark

    Jens Meldgaard Bruun & Esben Thyssen Vestergaard

  4. Department of Clinical Medicine, Aarhus University, Aarhus, Denmark

    Jens Meldgaard Bruun & Esben Thyssen Vestergaard

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  1. Rasmus Møller Jørgensen
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Contributions

JMB, EVT and RMJ conceived the original idea for the study. RMJ and RBF were responsible for data collection. RMJ analyzed data and all authors had access to the data during the process. RMJ wrote first draft of the manuscript and all authors were involved in revision and final approval of the manuscript.

Corresponding author

Correspondence to Rasmus Møller Jørgensen.

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Conflict of interest

None of the authors had any conflict of interest to declare. All authors completed an ICMJE “disclosure of potential conflicts of interest” form.

Ethical approval

This project was meant as a treatment option for children with obesity, and for that reason it was not necessary with ethical approval. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

Written information was handed out to the families and written consent was obtained for each participant completed by a parent or a legal guardian.

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Jørgensen, R.M., Bruun, J.M., Kremke, B. et al. Sustainable weight loss over three years in children with obesity: a pragmatic family-centered lifestyle intervention. Eat Weight Disord 26, 537–545 (2021). https://doi.org/10.1007/s40519-020-00887-7

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  • DOI: https://doi.org/10.1007/s40519-020-00887-7

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