title: Parental obesity and higher pre-intervention BMI reduce the likelihood of a multidisciplinary childhood obesity program to succeed--a clinical observation.
abstract: OBJECTIVE
  To assess the effects and identify factors associated with success of a combined, structured multidisciplinary weight management program in obese children and adolescents.
  
  
  METHODS
  Seventy-seven obese children (age 6-16 years) participated in a 12-month combined dietary-behavioral-exercise intervention. Thirty-seven (age and maturity comparable) obese children who did not participate in the structured program served as controls. Body weight, BMI, and BMI percentiles were measured at baseline, after 6 months, and at the end of the intervention.
  
  
  RESULTS
  The combined intervention was associated with a significant decrease in BMI (from 25.9+/-0.4 to 24.5+/-0.4 kg/m2, p <0.0005) and BMI percentile (from 97.3+/-0.2% to 92.6+/-0.9%, p <0.0005). In contrast, obese children who did not participate in the structured program gained weight (from 51.4+/-3.6 to 57.7+/-3.7 kg, p <0.0005), increased their BMI (from 25.2+/-1.0 to 26.6+/-0.9 kg/m2, p <0.0005), and had a non-significant increase in BMI percentiles (from 94.9+/-0.8% to 95.4+/-0.9%, NS). Children with higher BMI percentiles and parental overweight tended to respond less favorably to the combined multidisciplinary program (p <0.01).
  
  
  CONCLUSIONS
  A prolonged (12 mo), combined, structured multidisciplinary intervention for childhood obesity resulted in a significant decrease in BMI and BMI percentiles. Higher pre-intervention BMI percentiles and parental obesity were associated with less favorable responses to the combined intervention.
authors.affiliation: Child Health and Sports Center, Pediatric Department, Meir General Hospital, Kfar Saba and Sackler School of Medicine, Tel Aviv University, Israel. eliakim@internet-zahav.net
authors.forename: Alon
authors.initials: A
authors.lastname: Eliakim
authors.forename: Orit
authors.initials: O
authors.lastname: Friedland
authors.forename: Galit
authors.initials: G
authors.lastname: Kowen
authors.forename: Baruch
authors.initials: B
authors.lastname: Wolach
authors.forename: Dan
authors.initials: D
authors.lastname: Nemet
mesh_terms: D000293:Adolescent; D017195:Adolescent Nutritional Physiological Phenomena; D000328:Adult; D000886:Anthropometry; D001521:Behavior Therapy / Q000379:methods*; D015992:Body Mass Index; D002648:Child; D003131:Combined Modality Therapy; D004038:Diet, Reducing; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D009765:Obesity / Q000628:therapy*; D010290:Parents; D010353:Patient Education as Topic; D015397:Program Evaluation; D016896:Treatment Outcome; D015431:Weight Loss