Long-term weight control in obese children: persistence of treatment outcome and metabolic changes.
Maintenance of achieved weight loss and clinical and biochemical changes were studied in 48 obese children (relative weight greater than 120%) over a three-year period after active treatment for one year and initial observation for another year. The control group comprised 29 normal weight children (relative weight less than 120%). The children were 6-16 years old at the beginning of the study. The successful weight loser was defined as a child with a decrease of at least 10% in relative weight at the end of the initial two year study period. Twenty-two subjects (49%) were treated successfully while 23 children were unsuccessful. Three obese children dropped out of the study. In successful children the relative body weight decreased by 24.7% (P less than 0.001) during the initial two-year period, and the lower body weight was maintained during the subsequent observation. The relative height also decreased significantly in the successful subjects but was still normal at the end of the study. Success in weight reduction was associated with increased HDL-cholesterol (HDL-C) levels, increased ratio of HDL-C to total cholesterol and reduced concentrations of triglyceride and plasma insulin. All of these changes were maintained throughout the five year study period. In normal weight children concentrations of serum lipids and plasma insulin remained unchanged during the five years. In conclusion, initial success in weight loss was associated with long-term favourable changes in the serum lipid profile and reduced hyperinsulinemia. A majority of the initially successful weight losers (14 of 22) managed to maintain their reduced weight up to five years.
Nuutinen
O
O
Department of Clinical Nutrition, University of Kuopio, Finland.
Knip
M
M
D000273:Adipose Tissue / Q000033:anatomy & histology; D000293:Adolescent; D000886:Anthropometry; D001786:Blood Glucose / Q000032:analysis; D001794:Blood Pressure; D001823:Body Composition; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007328:Insulin / Q000097:blood; D008055:Lipids / Q000097:blood; D008297:Male; D009765:Obesity / Q000503:physiopathology / Q000628:therapy*; D016896:Treatment Outcome; D015431:Weight Loss / Q000502:physiology
D001786:Blood Glucose; D007328:Insulin; D008055:Lipids