title: Children With Morbid Obesity Benefit Equally as Children With Overweight and Obesity From an Ongoing Care Program.
abstract: BACKGROUND
  Despite stabilization of childhood overweight and obesity prevalence, there is a shift toward more severe degrees of obesity, which results in an increasing prevalence of children with morbid obesity. Prior studies demonstrated that lifestyle modification without ongoing treatment has only a modest and not sustainable effect in children with morbid obesity. This suggests that a chronic care model is necessary for long-term effects on weight management and health.
  
  
  OBJECTIVE
  This study aimed to evaluate the effect of an ongoing lifestyle intervention in children with morbid obesity in comparison with children with overweight and obesity.
  
  
  METHODS
  This was a nonrandomized prospective intervention study with 12- and 24-month followup at the Centre for Overweight Adolescent and Children's Healthcare.
  
  
  METHODS
  Children and adolescents (n = 100 females and 72 males) with overweight, obesity, or morbid obesity were given long-term, outpatient, tailored lifestyle intervention.
  
  
  METHODS
  Body mass index (BMI) z score was measured.
  
  
  RESULTS
  In children with morbid obesity, 12- and 24-month interventions resulted in a decrease of BMI z score of -0.13 ± 0.25 (P = .001) and -0.23 ± 0.32 (P = .01) respectively, whereas weight status category improved to obese in 21% and 25% of the children. Cardiovascular risk parameters including serum total cholesterol, low-density lipoprotein cholesterol, glycosylated hemoglobin (HbA1c), and diastolic blood pressure significantly improved after 1-year intervention in the complete group. Most important, BMI z score as well as cardiovascular risk parameters improved to a similar degree in children with overweight, obesity, and morbid obesity.
  
  
  CONCLUSIONS
  Children with overweight, obesity, and morbid obesity benefit equally from an ongoing, outpatient, tailored lifestyle intervention, and demonstrate significant weight loss and improvement of cardiovascular risk parameters.
authors.affiliation: Centre for Overweight Adolescent and Children's Healthcare, Department of Paediatrics (J.M.R., E.D.M., A.C.E.V.), Maastricht University Medical Centre, P. Debyelaan 25, 6229 HX Maastricht, The Netherlands; Department of Human Biology (J.P., R.P.M.), School of Nutrition and Translational Research in Metabolism (J.M.R., J.P., R.P.M., E.D., A.C.E.V.), Maastricht University, Universiteitssingel 6229 HR, Maastricht, The Netherlands; and Department of Neuropsychology & School for Mental Health and Neuroscience (W.A.B.), Maastricht University Medical Centre, P. Debyelaan 25, 6229 HX, Maastricht, The Netherlands.
authors.forename: J M
authors.initials: JM
authors.lastname: Rijks
authors.affiliation: Centre for Overweight Adolescent and Children's Healthcare, Department of Paediatrics (J.M.R., E.D.M., A.C.E.V.), Maastricht University Medical Centre, P. Debyelaan 25, 6229 HX Maastricht, The Netherlands; Department of Human Biology (J.P., R.P.M.), School of Nutrition and Translational Research in Metabolism (J.M.R., J.P., R.P.M., E.D., A.C.E.V.), Maastricht University, Universiteitssingel 6229 HR, Maastricht, The Netherlands; and Department of Neuropsychology & School for Mental Health and Neuroscience (W.A.B.), Maastricht University Medical Centre, P. Debyelaan 25, 6229 HX, Maastricht, The Netherlands.
authors.forename: J
authors.initials: J
authors.lastname: Plat
authors.affiliation: Centre for Overweight Adolescent and Children's Healthcare, Department of Paediatrics (J.M.R., E.D.M., A.C.E.V.), Maastricht University Medical Centre, P. Debyelaan 25, 6229 HX Maastricht, The Netherlands; Department of Human Biology (J.P., R.P.M.), School of Nutrition and Translational Research in Metabolism (J.M.R., J.P., R.P.M., E.D., A.C.E.V.), Maastricht University, Universiteitssingel 6229 HR, Maastricht, The Netherlands; and Department of Neuropsychology & School for Mental Health and Neuroscience (W.A.B.), Maastricht University Medical Centre, P. Debyelaan 25, 6229 HX, Maastricht, The Netherlands.
authors.forename: R P
authors.initials: RP
authors.lastname: Mensink
authors.affiliation: Centre for Overweight Adolescent and Children's Healthcare, Department of Paediatrics (J.M.R., E.D.M., A.C.E.V.), Maastricht University Medical Centre, P. Debyelaan 25, 6229 HX Maastricht, The Netherlands; Department of Human Biology (J.P., R.P.M.), School of Nutrition and Translational Research in Metabolism (J.M.R., J.P., R.P.M., E.D., A.C.E.V.), Maastricht University, Universiteitssingel 6229 HR, Maastricht, The Netherlands; and Department of Neuropsychology & School for Mental Health and Neuroscience (W.A.B.), Maastricht University Medical Centre, P. Debyelaan 25, 6229 HX, Maastricht, The Netherlands.
authors.forename: E
authors.initials: E
authors.lastname: Dorenbos
authors.affiliation: Centre for Overweight Adolescent and Children's Healthcare, Department of Paediatrics (J.M.R., E.D.M., A.C.E.V.), Maastricht University Medical Centre, P. Debyelaan 25, 6229 HX Maastricht, The Netherlands; Department of Human Biology (J.P., R.P.M.), School of Nutrition and Translational Research in Metabolism (J.M.R., J.P., R.P.M., E.D., A.C.E.V.), Maastricht University, Universiteitssingel 6229 HR, Maastricht, The Netherlands; and Department of Neuropsychology & School for Mental Health and Neuroscience (W.A.B.), Maastricht University Medical Centre, P. Debyelaan 25, 6229 HX, Maastricht, The Netherlands.
authors.forename: W A
authors.initials: WA
authors.lastname: Buurman
authors.affiliation: Centre for Overweight Adolescent and Children's Healthcare, Department of Paediatrics (J.M.R., E.D.M., A.C.E.V.), Maastricht University Medical Centre, P. Debyelaan 25, 6229 HX Maastricht, The Netherlands; Department of Human Biology (J.P., R.P.M.), School of Nutrition and Translational Research in Metabolism (J.M.R., J.P., R.P.M., E.D., A.C.E.V.), Maastricht University, Universiteitssingel 6229 HR, Maastricht, The Netherlands; and Department of Neuropsychology & School for Mental Health and Neuroscience (W.A.B.), Maastricht University Medical Centre, P. Debyelaan 25, 6229 HX, Maastricht, The Netherlands.
authors.forename: A C E
authors.initials: AC
authors.lastname: Vreugdenhil
mesh_terms: D000293:Adolescent; D001521:Behavior Therapy; D015992:Body Mass Index; D002648:Child; D005260:Female; D006801:Humans; D008019:Life Style; D008297:Male; D009767:Obesity, Morbid / Q000523:psychology / Q000628:therapy*; D050177:Overweight / Q000523:psychology / Q000628:therapy*; D011446:Prospective Studies; D016896:Treatment Outcome; D015431:Weight Loss