title: BMI changes in children and adolescents attending a specialized childhood obesity center: a cohort study.
abstract: BACKGROUND
  Multidisciplinary group therapies for obese children and adolescents are effective but difficult to implement. There is a crucial need to evaluate simpler management programs that target the obese child and his family. This study aimed to determine changes in body mass indexes (BMI) after individual family-based obesity intervention with a pediatrician in a specialized obesity center for child and adolescent.
  
  
  METHODS
  This cohort study included 283 patients (3.3 to 17.1 years, mean 10.7 ± 2.9) attending the Pediatric Obesity Care Program of the Geneva University Hospitals. Medical history and development of anthropometric were assessed in consultations. Pediatricians used an integrative approach that included cognitive behavioral techniques (psycho-education, behavioral awareness, behavioral changes by small objectives and stimulus control) and motivational interviewing. Forty five children were also addressed to a psychologist.
  
  
  RESULTS
  Mean follow-up duration was 11.4 ± 9.8 months. The decrease in BMI z-score (mean: -0.18 ± 0.40; p < .001) was significant for 49.5% of them. It was dependent of age, BMI at baseline (better in youngest and higher BMI) and the total number of visits (p = .025). Additional psychological intervention was associated with reduced BMI z-score in children aged 8 to 11 years (p = .048).
  
  
  CONCLUSIONS
  Individual family obesity intervention induces a significant weight reduction in half of the children and adolescents, especially in the youngest and severely obese. This study emphasizes the need to encourage trained pediatricians to provide individual follow up to these children and their family. Our study also confirms the beneficial effect of a psychological intervention in selected cases.
authors.affiliation: Pediatric sport medicine and obesity care program, Division of pediatric specialties, Department of Child and Adolescent, University Hospitals of Geneva and University of Geneva, 6, rue Willy-Donzé, 1211, Geneva 14, Switzerland. Albane.maggio@hcuge.ch.
authors.forename: Albane B R
authors.initials: AB
authors.lastname: Maggio
authors.forename: Catherine
authors.initials: C
authors.lastname: Saunders Gasser
authors.forename: Claudine
authors.initials: C
authors.lastname: Gal-Duding
authors.forename: Maurice
authors.initials: M
authors.lastname: Beghetti
authors.forename: Xavier E
authors.initials: XE
authors.lastname: Martin
authors.forename: Nathalie J
authors.initials: NJ
authors.lastname: Farpour-Lambert
authors.forename: Catherine
authors.initials: C
authors.lastname: Chamay-Weber
mesh_terms: D000293:Adolescent; D015992:Body Mass Index; D002648:Child; D002675:Child, Preschool; D015928:Cognitive Behavioral Therapy; D015331:Cohort Studies; D015897:Comorbidity; D003376:Counseling; D005196:Family Therapy; D005260:Female; D006785:Hospitals, University; D006801:Humans; D007406:Interview, Psychological; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology / Q000628:therapy; D009042:Motivation; D009765:Obesity / Q000453:epidemiology / Q000523:psychology / Q000628:therapy*; D010044:Outpatient Clinics, Hospital; D015397:Program Evaluation; D011446:Prospective Studies; D013557:Switzerland; D016896:Treatment Outcome