A family-based education program for obesity: a three-year study.
BACKGROUND
The epidemic of obesity is increasing in all countries. However, the number of controlled studies focusing on childhood obesity, with a long follow-up is still limited. Even though Behavioral Therapy shows some efficacy, it requires a prolonged teamwork that is not always available in public health settings. In addition, Behavioral Therapy is not always accepted. We describe a new intensive and sustainable family-based, Therapeutic Education program for childhood obesity.


METHODS
Controlled clinical study: a family-based Therapeutic Education program without dietetic prescription involving overweight and obese children/adolescents, without evident psychological troubles, and their families. The program consisted of three clinical and therapeutic education sessions, carried out by a single physician. Further sessions were carried out every six months in the first year and then every year.


METHODS
190 overweight children, 85 treated with a therapeutic education program (45 males and 40 females, mean age of 10.43 +/- 3) with an average BMI% of 154.72 +/- 19.6% and 105 matched children, treated with traditional dietary approach.Children's Body Mass Index (BMI) % and BMI Standard Deviation Score measured at baseline and after a three year-follow-up, were compared. Statistical tests: ANOVA-RM (repeated measures) controlled for distribution by Kolmogorov-Smirnov, Bartlett's test or correspondent non-parametric procedures, X2 tests or Fisher's exact test and simple linear regression.


RESULTS
After a follow-up of 2.7 +/- 1.1 years, 72.9% of the children who followed the Therapeutic Education Program obtained a BMI% reduction, compared to 42.8% of children who followed the traditional dietary treatment. Weight reduction was good in moderately obese children and in the severely obese. In addition, a smaller proportion of children treated with therapeutic education had negative results (BMI increase of >10%) compared to those treated with dietary approach (11.8% vs. 25.7%); finally, periodic phone calls reduced the drop-out rate in the therapeutic education group.


CONCLUSIONS
These results indicate the efficacy and sustainability of the Therapeutic Education program, that was completely carried out by a single pediatrician; in addition, it met with an elevated participant acceptance, suggesting a convenient therapeutic solution for skilled pediatricians and selected obese children, when Behavioral Therapy is not available or teamwork is poor.
Tanas
Rita
R
Pediatric Department, Azienda Ospedaliera-Universitaria S, Anna, Ferrara, Italy. tanas.rita@tin.it
Marcolongo
Renzo
R
Pedretti
Stefania
S
Gilli
Giuseppe
G
D000293:Adolescent; D000704:Analysis of Variance; D015992:Body Mass Index; D002648:Child; D002675:Child, Preschool; D005190:Family; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009765:Obesity / Q000178:diet therapy / Q000523:psychology / Q000628:therapy*; D050177:Overweight / Q000178:diet therapy / Q000523:psychology / Q000628:therapy*; D010290:Parents / Q000193:education*; D010353:Patient Education as Topic / Q000379:methods*; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D015431:Weight Loss