Predictors and determinants for weight reduction in overweight and obese children and adolescents

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• 作者：Ralf Schiel¹ ; ^{r.schiel@medigreif-inselklinikum.de} ; Alexander Kaps¹ ; Gü ; nter Stein² ; Antje Steveling³
• 关键词：obesity ; body mass index ; quality of life ; well-being ; resilience ; sense of coherence
• 刊名：Zeitschrift für Evidenz, Fortbildung und Qualität im Gesundheitswesen
• 出版年：2016
• 出版时间：December 2016
• 年：2016
• 卷：118-119
• 期：Complete
• 页码：31-39
• 全文大小：736 K
• 卷排序：118

文摘

Worldwide, overweight and obesity are known as posing serious health risks. Successful methods for weight reduction have remained elusive. This multicenter non-randomised trial aimed to identify parameters and determinants of long-term weight reduction.Patients and methodsA total of 143/159 overweight and obese children and adolescents (90 %) completed the prospective multicenter trial (age 13.9 ± 2.4 years, BMI 31.2 ± 5.4 kg/m2, BMI-SDS 2.51 ± 0.57). During a 6-week rehabilitation period the patients participated in a structured treatment and teaching program (STTP). Following in-patient treatment the children and adolescents were monitored over a period of 24 months (physical examination, measurements of BMI, BMI-SDS, body composition, carotid intima-media thickness, laboratory parameters, blood pressure, standardized questionnaires to assess socio-demographic and socio-economic parameters, eating behavior, well-being, quality of life, intelligence, intrafamilial conflicts, self-efficacy, resilience, sense of coherence, stress management, social support, actual body shape).Results66% of the children and adolescents had abnormal laboratory parameters as well as higher blood pressure and/or an increased carotid intima-media thickness. The mean carotid intima-media thickness was 0.53 ± 0.09 mm (range 0.40 to 0.80); 15% of the patients showed normal range values (< 0.45 mm), 40% a slightly elevated (≥ 0.45 to ≤ 0.50 mm) and 45% an elevated (> 0.50 mm) thickness. After the inpatient treatment lasting 40.4 ± 4.1 (range 28 to 49) days, children and adolescents reached a mean weight reduction of 5.52 ± 3.94 (0.4 to 13.3) kg (p < 0.01) that was accompanied by a reduction in body fat mass. Using multivariate analyses, the most important psychological factors associated with long-term weight reduction were identified (R-square = 0.53): well-being (β = -0.543), resilience (β = 0.434), and sense of coherence (β = 0.315).ConclusionThe different parameters (i. e., well-being, resilience, sense of coherence) have demonstrated their utility, and strategies should be developed allowing an adaption of these into the STTPs.