Childhood Obesity Clinical Trial
Official title:
A Three-year Behavioral Treatment of Obese Children: the Effect of Age on Change in BMI SDS and Dropout Rate
The prevalence of overweight and obesity among children and adolescents has reached epidemic
proportions worldwide. Among Swedish 10-year old children 15-20% are overweight and 3-5% are
obese. The probability that an obese child becomes an obese adult is very high. This chronic
disease requires lifetime treatment. The standard treatment of childhood obesity involves
behavioural interventions focused on eating habits and physical activity. Studies often
include small study samples, the absence of control groups and short treatments times.
Several long-term follow-up studies of shorter interventions are available. The results from
these studies are disappointing since the number of children who are "cured" i.e., have
become non-obese is low. Thus, effective treatments are currently lacking.The National
Childhood Obesity Center treats children in a University hospital setting. The children are
enrolled from the catchment areas of the hospital as well as the rest of Sweden. Treatment
alternatives include behavioural treatment (individual and group), low and very low calorie
diet, pharmacological and surgical treatment. Patients treated with surgical and
pharmacological methods safety is ensured using these treatments exclusively in controlled
studies. The clinic was the first in Sweden with this wide range of treatment options.
BORIS is a national health care quality register for childhood obesity, supervised by the
Swedish Association of Local Authority and Regions.
The primary aim of this study was to compare treatment effects (changes in BMI SDS) during
the first three years of behavioral treatment in relation to age at start of treatment. The
secondary aim was to evaluate specific factors of importance (gender, heredity, parental
weight status, socioeconomic factors and age at obesity onset) for treatment effects. The
third aim was to investigate factors correlated to drop out.
This is a longitudinal study of all patients referred to National Childhood Obesity Center
between January 1997 and December 2004. Only patients with behavioral treatment were
included. Patients with other treatments (VLCD/LCD, drugs and surgery) and other diagnoses
(syndromes, craniopharyngioma, Mb Down, myelomeningocele, various types of mental and
psychological disorders) and children <6 and >17 year at inclusion were excluded. The
remaining children were divided into three age groups of obese children depending of age at
onset of obesity treatment (6-9, 10-13 and 14-16year). All patient data were registered in
the BORIS nationwide childhood obesity database.
;
Allocation: Non-Randomized, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment
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