title: Childhood obesity: concept, feasibility, and interim results of a local group-based, long-term treatment program.
abstract: OBJECTIVE
  The authors performed a group-based program for obese children and adolescents in Bavaria, Germany to enable them to establish a health-oriented lifestyle and to reduce overweight. The authors compared this program with a control approach based on the patients' own initiative.
  
  
  METHODS
  This is a controlled clinical trial.
  
  
  METHODS
  A nutrition program for outpatients in a German university hospital.
  
  
  METHODS
  Seventy-three obese patients aged 7 to 15 years (mean 11.2 years) were recruited by pediatricians and local newspaper reports and randomized into intervention and control groups. Children and adolescents in each group were divided into 3 groups according to age--7-8 years, 9-10 years, and 11-13 years. Children were classified overweight (defined as body mass index (BMI) > 90th percentile for age and gender), obese (BMI > 97th percentile), and extremely obese (BMI > 99.5th percentile), according to the European Childhood Obesity Group and the German Working Group on Pediatric Obesity, congruent with adult standards used to assess overweight and obesity.
  
  
  METHODS
  Thirty-seven patients (age 7-13 years, mean 10.9 years) for the 1-year intervention. This intervention consisted of modules for physical activity, nutritional education, and coping strategies. The program was performed twice each week and incorporated parental participation and medical supervision, including laboratory tests. The obese controls (n = 36, age 8-15 years, mean 11.6 years) received written therapeutic advice during a visit at 0 and 6 months in the outpatient clinic.
  
  
  METHODS
  The primary outcome variable was the body mass index (BMI) z score.
  
  
  METHODS
  Analysis of variance and t test were used, and a P value < .05 was considered significant.
  
  
  RESULTS
  There was a reduction of BMI z score in the active treatment group (P < .05), but not for controls. Moreover, the active group showed beneficial effects for body mass index (BMI), fat mass, and systolic blood pressure 12 months after beginning the intervention.
  
  
  CONCLUSIONS
  Group-based programs for young, obese patients can be effective tools for establishing a health-oriented lifestyle and reducing the burden of obesity.
authors.affiliation: Children's and Adolescents' Hospital, University of Erlangen-Nuremberg, Germany.
authors.forename: Corina
authors.initials: C
authors.lastname: Weigel
authors.forename: Kathrin
authors.initials: K
authors.lastname: Kokocinski
authors.forename: Peter
authors.initials: P
authors.lastname: Lederer
authors.forename: Jorg
authors.initials: J
authors.lastname: Dötsch
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Rascher
authors.forename: Ina
authors.initials: I
authors.lastname: Knerr
mesh_terms: D000293:Adolescent; D000704:Analysis of Variance; D015992:Body Mass Index; D002648:Child; D053198:Child Nutrition Sciences / Q000193:education*; D003131:Combined Modality Therapy; D005240:Feasibility Studies; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008019:Life Style; D008297:Male; D009765:Obesity / Q000453:epidemiology / Q000517:prevention & control / Q000628:therapy*; D009767:Obesity, Morbid / Q000453:epidemiology / Q000517:prevention & control / Q000628:therapy; D050177:Overweight / Q000453:epidemiology / Q000517:prevention & control / Q000628:therapy; D010353:Patient Education as Topic; D015397:Program Evaluation; D016896:Treatment Outcome; D015431:Weight Loss