title: A controlled study of lifestyle treatment in primary care for children with obesity.
abstract: BACKGROUND
  Lifestyle intervention is the most common treatment strategy for children with obesity. Specialized units for the care of children with obesity report significant effects of lifestyle treatment. In children, the physical activity component in lifestyle treatment is often well accepted.
  
  
  CONCLUSIONS
  Two lifestyle treatment programmes in primary care for children with obesity both gave a reduction of body mass index significantly greater than the change observed in a non-intervention comparison group of children with obesity. Substituting one-third of nurse-led treatment sessions with sessions led by physiotherapists in one of the programmes did not improve the outcome. The efficacy of treatment in primary care seems to be comparable to that reported in the literature.
  
  
  OBJECTIVE
  To evaluate the efficacy of lifestyle treatment in primary care for children with obesity.
  
  
  METHODS
  In a multicentre study, sixty-four 9- to 13-year-old children with obesity were randomized to one of two 12-month lifestyle treatment programmes. The only difference between the programmes was that a physiotherapist substituted the nurse in one-third of the sessions in an attempt to stimulate physical activity. For comparison, children with normal weight and overweight, and an age-, sex- and body mass index-matched non-intervention group of children with obesity were used.
  
  
  RESULTS
  Anthropometry and laboratory data differed significantly between children with obesity and normal weight at baseline. The follow-up at the end of treatment was attended by 55 children with obesity, 28 and 27 in each treatment arm. The mean (standard deviation) body mass standard deviation score changed by -0.36 (0.3) in the arm involving a physiotherapist and by -0.33 (0.2) in the other arm. These outcomes were not significantly different. Both reductions were significantly greater than the change of -0.14 (0.3) observed in the non-intervention comparison group of children with obesity
  
  
  CONCLUSIONS
  The efficacy of treatment in primary care for children with obesity seems to be comparable to that reported in the literature. ISRCTN44919688.
authors.affiliation: Department of Paediatrics, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, Göteborg, Sweden. staffan.marild@pediat.gu.se
authors.forename: S
authors.initials: S
authors.lastname: Mårild
authors.forename: E
authors.initials: E
authors.lastname: Gronowitz
authors.forename: C
authors.initials: C
authors.lastname: Forsell
authors.forename: J
authors.initials: J
authors.lastname: Dahlgren
authors.forename: P
authors.initials: P
authors.lastname: Friberg
mesh_terms: D000293:Adolescent; D001823:Body Composition; D015992:Body Mass Index; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008019:Life Style; D008297:Male; D009765:Obesity / Q000453:epidemiology* / Q000517:prevention & control / Q000628:therapy*; D011320:Primary Health Care; D013548:Sweden / Q000453:epidemiology; D016896:Treatment Outcome