title: Four-year follow-up of children and adolescents participating in an obesity intervention program.
abstract: BACKGROUND
  Since obesity affects children's health and social integration, treatment concepts with long-term efficiency are necessary.
  
  
  METHODS
  We analyzed changes of standard deviation score of body mass index (SDS-BMI) quarterly in the first year and once a year during the next 3 years in all obese children participating in the 1-year outpatient intervention program 'Obeldicks', which was based on physical exercise, nutrition education and behavior therapy. All analyses were performed on the intention-to-treat approach.
  
  
  RESULTS
  One hundred and thirty-one children (77%) of the 170 children (mean age 10.5 years, 51% female, mean BMI 26.9 kg/m(2), mean SDS-BMI 2.54) attending the 'Obeldicks' intervention program reduced their overweight at the end of intervention (mean SDS-BMI reduction 0.41) and 122 (66%) 3 years after end of intervention (mean SDS-BMI reduction 0.48). The reduction of overweight was independent of the child's gender, age and parental age and BMI. Reduction of 0.33 SDS-BMI in the first 3 months was the best predictor for long-term success (95% predictive value).
  
  
  CONCLUSIONS
  Participating in the 1-year outpatient obesity intervention program 'Obeldicks' was associated with a decrease of overweight, which was sustained 3 years after the end of intervention. Reduction of overweight in the first 3 months of the intervention was highly predictive for long-term success.
authors.affiliation: Department of Pediatric Endocrinology, Vestische Kinderklinik Datteln, University of Witten-Herdecke, Witten-Herdecke, Germany. T.Reinehr@kinderklinik-datteln.de
authors.forename: T
authors.initials: T
authors.lastname: Reinehr
authors.forename: M
authors.initials: M
authors.lastname: Temmesfeld
authors.forename: M
authors.initials: M
authors.lastname: Kersting
authors.forename: G
authors.initials: G
authors.lastname: de Sousa
authors.forename: A M
authors.initials: AM
authors.lastname: Toschke
mesh_terms: D000293:Adolescent; D000554:Ambulatory Care Facilities / Q000458:organization & administration*; D001521:Behavior Therapy; D015992:Body Mass Index; D002648:Child; D002662:Child Health Services / Q000458:organization & administration*; D015444:Exercise; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009765:Obesity / Q000178:diet therapy* / Q000523:psychology; D050177:Overweight / Q000178:diet therapy* / Q000523:psychology; D010353:Patient Education as Topic; D011237:Predictive Value of Tests; D015397:Program Evaluation; D016896:Treatment Outcome