title: Effects of a combined intervention for treating severely obese prepubertal children.
abstract: BACKGROUND
  Obesity has become the most common modern pediatric chronic disease. Early prevention and treatment of childhood and adolescent obesity is mandated. Severe obesity [body mass index (BMI) percentile >98%] reduces the likelihood of the multidisciplinary childhood obesity program to succeed, suggesting, most probably, that a more intense program is needed to treat severely obese children.
  
  
  OBJECTIVE
  To prospectively examine the effects of an intense, 3-month, combined dietary-behavioral-physical activity intervention on anthropometric measures, leisure time activity patterns, and fitness in prepubertal severely obese (BMI percentile >98%) children (n=22) compared to age, gender, and obesity matched controls (n=18).
  
  
  RESULTS
  At 3 months, there were significant differences (p<0.05) in changes in body weight (-0.5±2.4 vs. 1.7±1.9 kg), BMI (-0.9±1.2 vs. 0.4±1.0 kg/m2), BMI percentile (0.39±0.39% vs. -0.04±0.32%), sum skinfolds (-3.1±8.1 vs. 1.1±4.7 mm), total habitual physical activity (25.4±10.8 vs. 0.3±10.1 Mets), and fitness (142±72 vs. -8±88 s) in the intervention vs. control participants.
  
  
  CONCLUSIONS
  Our data demonstrate the beneficial, short-term effects of an intense combined dietary-behavioral-physical activity intervention on anthropometric measures, activity patterns, and fitness in severely obese children. However, despite the encouraging results, the modest effect on BMI percentiles emphasizes the difficulty of treating severely obese children using the conventional nutritional-behavioral-physical activity approach.
authors: Department of Pediatrics, Meir Medical Center, Tel-Aviv University, Israel. dnemet@gmail.com
authors: Dan
authors: D
authors: Nemet
authors: Idan
authors: I
authors: Ben-Haim
authors: Michal
authors: M
authors: Pantanowits
authors: Alon
authors: A
authors: Eliakim
mesh_terms: D017668:Age of Onset; D001521:Behavior Therapy; D015992:Body Mass Index; D002648:Child; D003131:Combined Modality Therapy; D004038:Diet, Reducing; D005081:Exercise Therapy; D005260:Female; D006801:Humans; D008297:Male; D009043:Motor Activity / Q000502:physiology; D009767:Obesity, Morbid / Q000453:epidemiology / Q000628:therapy*; D012720:Severity of Illness Index; D012885:Skinfold Thickness; D061217:Weight Reduction Programs