title: Effects of a multidisciplinary inpatient intervention on body composition, aerobic fitness, and quality of life in severely obese girls and boys.
abstract: OBJECTIVE
  The last few decades have seen a major increase in the prevalence of juvenile obesity. Inpatient treatment programs are used mainly in children with severe obesity and related comorbidities. The aim of this study was to evaluate the gender differences of an 8-week multidisciplinary inpatient program on body weight, body composition, aerobic fitness, and quality of life of severely obese children and adolescents.
  
  
  METHODS
  Body weight was measured daily, and body composition, aerobic fitness, and quality of life were measured at the beginning and the end of an 8-week multidisciplinary inpatient program in 130 severely obese patients (52 girls, 78 boys), median (25th, 75th percentile) age of 13.8 (12.1, 15.0) years, median body weight of 89.4 kg (77.1, 100.1), and a body mass index of 33.4 (30.1, 36.6) kg/m(2), which is well above the 98th percentile. The inpatient program was based on a multidisciplinary treatment and education program that focused on daily physical activity, a 1200-1600 kcal/day balanced nutrition regimen, and a behavior modification therapy.
  
  
  RESULTS
  All results are expressed as medians (25th, 75th percentiles). At the end of the program all patients had lost a significant amount of body weight: 12.7 kg (10.8, 16.6), p < .001, girls 11.6 kg (9.7, 13.2), boys 13.7 kg (11.7, 17.3), p < .001, absolute body fat 8.0 kg (6.8, 10.0) p < 001, girls 7.0 kg (5.7, 8.1), boys 9.4 kg (7.6, 11.0) p < .001, % body fat per kg body weight: 4.9% (3.2, 6.6) p < .001, girls 3.7% (2.7, 4.9), boys 5.7% (4.0, 7.5) p < .001, and absolute fat free (or lean body) mass: 1.8 kg (0.64, 3.0) p < .001, girls 1.8 kg (0.87, 3.2), boys 1.7 kg (0.50, 2.9) p = .43. In addition, all measurements of aerobic fitness: VO(2)peak (mL/min.kg) and peak mechanical power (watts and watt/kg) and of quality of life increased significantly (p < .001, p < .001, p < .004 to p < .001).
  
  
  CONCLUSIONS
  A multidisciplinary inpatient treatment program including moderate calorie restriction, daily physical activity, and behavior modification induced a major weight loss, a decrease in body fat, and an increse in aerobic fitness as well as the quality fo life of severely obese children and adolescents. Weight loss and the decrease in body fat (absolute and percent) were significantly more pronounced in boys than girls.
authors.affiliation: Alpine Children's Hospital Davos, Switzerland. chefarzt@kinderklinik-davos.ch
authors.forename: Bruno H
authors.initials: BH
authors.lastname: Knöpfli
authors.forename: Thomas
authors.initials: T
authors.lastname: Radtke
authors.forename: Marc
authors.initials: M
authors.lastname: Lehmann
authors.forename: Barbara
authors.initials: B
authors.lastname: Schätzle
authors.forename: Julia
authors.initials: J
authors.lastname: Eisenblätter
authors.forename: Angela
authors.initials: A
authors.lastname: Gachnang
authors.forename: Pius
authors.initials: P
authors.lastname: Wiederkehr
authors.forename: Jürg
authors.initials: J
authors.lastname: Hammer
authors.forename: Joanne
authors.initials: J
authors.lastname: Brooks-Wildhaber
mesh_terms: D000293:Adolescent; D000367:Age Factors; D000886:Anthropometry; D001823:Body Composition; D015992:Body Mass Index; D002648:Child; D015331:Cohort Studies; D003131:Combined Modality Therapy; D004038:Diet, Reducing; D015444:Exercise; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007297:Inpatients; D008297:Male; D009767:Obesity, Morbid / Q000175:diagnosis / Q000628:therapy*; D010349:Patient Compliance; D010809:Physical Fitness / Q000502:physiology*; D011336:Probability; D011788:Quality of Life; D018570:Risk Assessment; D012737:Sex Factors; D018709:Statistics, Nonparametric; D013557:Switzerland; D016896:Treatment Outcome; D015431:Weight Loss