[Group therapy versus individual follow-up in the management of the obese child].
OBJECTIVE
To compare the 1-year outcome of obese children managed medically and dietetically in a group setting with those managed individually.


METHODS
Two hundred and seventy-eight obese children [168 girls and 110 boys; body mass index (BMI) > + 2 SD] were followed by the Department of Pediatrics of the University Hospital of Angers between January 1996 and December 2002 (175 children in a group setting and 103 individually). The group program consisted of 3 monthly sessions of slide shows for groups of 10 children, followed by individual consultations once every 3 months alternating medical and dietetic concerns. The individual program consisted of successive medical and dietetic consultations on the same day once every 3 months.


RESULTS
The children were 10.3 +/- 2.9 years old, and their BMI was 5.5 +/- 2.1 SD, with no difference between groups. The drop-out rate (children not returning after the 1st consultation) was 17%, with no difference between groups. The drop-out rate after 1 year was 65% in the group program and 41% in the individual program (p < 0.05). Of the children who were followed for 1 year, 88% of those treated in a group setting had stabilized or reduced their BMI, whereas 74% of the individually-treated children had done so (p < 0.05).


CONCLUSIONS
Among obese children followed for 1 year, group treatment resulted in a greater percentage of stabilization or reduction in BMI than did individual treatment, although the drop-out rate was higher in the group setting. Psychological support and physical activity sessions adapted for obese children would help to maintain motivation in these children.
Dufresne
S
S
Unité d'endocrinologie diabétologie pédiatrique, pôle mêdicochirurgical de l'enfant, CHU d'Angers, 4, rue Larrey, 49000 Angers, France.
Bellanger
S
S
Bouhours-Nouet
N
N
Akhdar
M
M
Py
I
I
Gatelais
F
F
Coutant
R
R
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009765:Obesity / Q000628:therapy*; D011615:Psychotherapy, Group