title: One-year effects of two intensive inpatient treatments for severely obese children and adolescents.
abstract: Intensive inpatient lifestyle treatment may be a suitable alternative for severely obese children and adolescents who do not benefit from ambulatory obesity treatment. The aim was to evaluate the effectiveness of two intensive one-year lifestyle treatments with varying inpatient periods for severely obese children and adolescents with regard to SDS-BMI and cardiometabolic risk factors.
  
  
  
  The study was designed as a randomized controlled trial with two active treatment groups. Eighty participants (8-19 years) with severe obesity received treatment at a specialized childhood obesity center in the Netherlands. Severe obesity was defined as a SDS-BMI ≥ 3.0 or a SDS-BMI ≥ 2.3 in combination with obesity-related comorbidity. Participants received an intensive one-year lifestyle treatment with an inpatient period of either two months and biweekly return visits during the next four months (short-stay group) or six months (long-stay group), both followed by six monthly return visits. Outcomes were assessed at baseline, six and 12 months and included SDS-BMI as primary outcome and cardiometabolic risk factors such as SDS-waist circumference, systolic- and diastolic blood pressure, and blood measurements as secondary outcomes. To evaluate differences in the course of the primary- and secondary outcomes over time between the two treatment groups, Generalized Estimating Equations (GEE) were performed.
  
  
  
  No differences in the course of SDS-BMI or secondary outcomes over time were found between the two treatment groups after one year of treatment. SDS-BMI decreased statistically significantly after one year of treatment compared with baseline in both groups (0.33 (0.48) in the short-stay and 0.52 (0.49) in the long-stay group). Similar results were found for SDS-waist circumference, diastolic blood pressure and HDL-cholesterol.
  
  
  
  Since there were no significant differences in effects between the short- and long-stay treatment and considering the burden of the long-stay treatment for children and families, we recommend implementation of the short-stay treatment.
  
  
  
  Netherlands Trial Register NTR1678 , registered 20-Feb-2009.
authors.affiliation: Department of Health Sciences and the EMGO Institute for Health and Care Research, VU University Amsterdam, Amsterdam, The Netherlands.
authors.forename: Sabine
authors.initials: S
authors.lastname: Makkes
authors.affiliation: Department of Health Sciences and the EMGO Institute for Health and Care Research, VU University Amsterdam, Amsterdam, The Netherlands.
authors.forename: Carry M
authors.initials: CM
authors.lastname: Renders
authors.affiliation: Department of Health Sciences and the EMGO Institute for Health and Care Research, VU University Amsterdam, Amsterdam, The Netherlands.
authors.forename: Judith E
authors.initials: JE
authors.lastname: Bosmans
authors.affiliation: Merem Childhood Obesity Center, Heideheuvel, Hilversum, The Netherlands.
authors.forename: Olga H
authors.initials: OH
authors.lastname: van der Baan-Slootweg
authors.affiliation: Department of Health Sciences and the EMGO Institute for Health and Care Research, VU University Amsterdam, Amsterdam, The Netherlands.|Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: Trynke
authors.initials: T
authors.lastname: Hoekstra
authors.affiliation: Department of Health Sciences and the EMGO Institute for Health and Care Research, VU University Amsterdam, Amsterdam, The Netherlands. j.c.seidell@vu.nl.|Department of Health Sciences, Faculty of Earth and Life Sciences, Section Prevention and Public Health, VU University Amsterdam, De Boelelaan 1085, 1081 HV, Amsterdam, The Netherlands. j.c.seidell@vu.nl.
authors.forename: Jacob C
authors.initials: JC
authors.lastname: Seidell
mesh_terms: D000293:Adolescent; D001786:Blood Glucose / Q000378:metabolism; D001794:Blood Pressure; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000209:etiology / Q000517:prevention & control; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007328:Insulin / Q000097:blood; D057194:Intention to Treat Analysis; D007902:Length of Stay; D008019:Life Style; D008055:Lipids / Q000097:blood; D008297:Male; D009426:Netherlands; D009767:Obesity, Morbid / Q000150:complications / Q000628:therapy*; D063766:Pediatric Obesity / Q000150:complications / Q000628:therapy*; D012307:Risk Factors; D016896:Treatment Outcome; D055105:Waist Circumference
chemical_list: D001786:Blood Glucose; D007328:Insulin; D008055:Lipids
keywords: Adolescent; Child; Lifestyle; Morbid obesity; Treatment effectiveness