Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Paper
  • Published:

Predictors to success in outpatient training in obese children and adolescents

International Journal of Obesity volume 27, pages 1087–1092 (2003)Cite this article

Abstract

OBJECTIVE: The treatment of obese children and adolescents is not yet satisfactorily effective. It is not clear which participants can profit by a long-time outpatient therapy.

DESIGN: Longitudinal, clinical intervention study based on a 1-y outpatient training programme consisting of physical exercise, nutrition course and behaviour therapy for children and their parents.

SUBJECTS: A total of 75 obese children (age 7–15 y; standard duration scores of body mass index(SDS-BMI)+1.9–+3.8).

MEASUREMENTS: We characterised the participants as to their willingness to change their behaviour (changes in weight status, number of attempts at therapy, participation in exercise groups), somatic characteristics (BMI of children and family members, gender, age), socioeconomic status (level of education of the children and their parents, working mother), exercise and dietary habits, dietary intake as well as the quality of dietary records. These factors were related to the success of the treatment using a multiple logistic regression.

RESULTS: A total of 27 (37%) of the children were unsuccessful after treatment. For 48 (63%) of the children, there was a median weight loss of about 0.4 SDS-BMI (range −0.2 to −1.1). The only significant difference (P<0.0001) between these successful children and the unsuccessful ones was that they had taken part in the exercise groups before training began.

CONCLUSION: A training for the obese children and their parents enables the majority of the participants to reduce weight. Previous participation in exercise groups can be considered as a predictor to success of the treatment.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Figure 1

Similar content being viewed by others

References

  1. Kromeyer-Hausschild K, Zellner K, Jaeger U, Hoyer H . Prevalence of overweight and obesity among school children (Germany). Int J Obes Relat Metab Disord 1999; 23: 1143–1150.

    Google Scholar 

  2. Livingstone B . Epidemiology of childhood obesity in Europe. Eur J Pediatr 2000; 159 (Suppl 1): 14–34.

    Google Scholar 

  3. Barlow SE, Dietz WH . Obesity evaluation and treatment: Expert Committee recommendations. The Maternal and Child Health Bureau, Health Resources and Services Administration and the Department of Health and Human Siences. Pediatrics 1998; 102: 1–11.

    Google Scholar 

  4. Ebbeling CA, Pawlak DB, Ludwig DS . Childhood obesity: public-health crisis, common sense cure. Lancet 2002; 360: 473–482.

    Google Scholar 

  5. Edmunds L, Waters E, Elliott EJ . Evidence based management of childhood obesity. BMJ 2001; 323: 916–919.

    CAS  PubMed  PubMed Central  Google Scholar 

  6. Jeffrey RW, Drewnowski A, Epstein LH, Stunkard AJ, Wilson GT, Wing RR, Hill DR . Long-term maintenance of weightloss: current status. Health Psychol 2000; 19 (Suppl 1): 5–16.

    Google Scholar 

  7. Reinehr T, Wollenhaupt A, Chahda C, Kersting M, Andler W . Ambulant training program for obese children. Criterions of comparison for the development of valid therapy recommendations. Klin Padiatr 2002; 214: 83–88.

    CAS  PubMed  Google Scholar 

  8. Epstein LH, Valoski A, Wing R, McCurley J . Ten year outcomes of behavorial family-based treatment for childhood obesity. Health Psychol 1994;13: 373–383.

    CAS  PubMed  Google Scholar 

  9. Epstein LH, Roemmich JN, Raynor HA . Behavioral therapy in the treatment of pediatric obesity. Pediatr Clin N Am 2001; 48: 981–993.

    CAS  Google Scholar 

  10. Kirschenbaum DS, Harris ES, Tomarken AJ . Effects of parental involvement in behaviorial weight loss therapy for preadolescents. Behav Ther 1984; 15: 266–272.

    Google Scholar 

  11. Cole TJ, Bellizzi MC, Flegal KM, Dietz WH . Establishing a standard definition for child overweight and obesity worldwide: international survey. BMJ 2000; 320: 1240–1243.

    CAS  PubMed  PubMed Central  Google Scholar 

  12. Reinehr T, Bürk G, Damschen U, Chahda C, Kersting M, Andler W . Ambulant training program ‘Obeldicks’ for obese children and adolescents. Kinder Jugendmedizin 2001; 82: 33–36.

    Google Scholar 

  13. Reinehr T, Dobe M, Kersting M (eds). Therapie der Adipositas im Kindesalter—Adipositasschulung Obeldicks. Verlag für Psychologie Dr CJ Hogrefe: Göttingen; 2003.

    Google Scholar 

  14. Kersting M, Sichert-Hellert W, Lausen B, Alexy U, Manz F, Schöch G . Energy intake of 1 to 18 year old German Children and adolescents. Z Ernährungswiss 1998; 37: 47–55.

    CAS  PubMed  Google Scholar 

  15. Kromeyer-Hauschild K, Wabitsch M, Geller F, Ziegler A, Geiß HC, Hesse V, v Hippel, Jaeger U, Johnsen D, Kiess W, Korte W, Kunze D, Menner K, Müller M, Niemann-Pilatus A, Remer Th, Schaefer F, Wittchen HU, Zabransky S, Zellner K, Hebebrand J . Percentiles of body mass index in children and adolescents evaluated from different regional German studies. Monatsschr Kinderheilkd 2001; 149: 807–818.

    Google Scholar 

  16. Pudel V, Westenhöfer J (eds). Fragebogen zum Eßverhalten (FEV)-Handanweisung. Verlag für Psychologie Dr CJ Hogrefe: Göttingen; 1989.

    Google Scholar 

  17. Goldberg GR, Black AE, Jebb SA, Cole TJ, Murgatroyd PR, Coward WA, Prentice AM . Critical evaluation of energy intake data using fundamental principles of energy physiology: 1. Derivation of cut-off limits to identify under-recording. Eur J Clin Nutr 1991; 45: 569–581.

    CAS  PubMed  Google Scholar 

  18. Schofield WN . Predicting basal metabolic rate, new standards and review of previous work. Hum Nutr Clin Nutr 1985; 39 (Suppl 1): 5–41.

    Google Scholar 

  19. Sichert-Hellert, Kersting M, Schöch G . Underreporting of energy intake in 1 to 18 year old German children and adolescents. Z Ernährungswiss 1998; 37: 242–251.

    CAS  PubMed  Google Scholar 

  20. Hansen D, Astrup A, Toubro S, Finer N, Kopelman P, Hilsted J, Rossner S, Saris W, van Gall L, James W . Predictors of weight loss and maintenance during 2 years of treatment by sibutramine in obesity. Results from the European multi-centre STORM trail. Int J Obes Relat Metab Disord 2001; 25: 496–501.

    CAS  PubMed  Google Scholar 

  21. Golan M, Weizman A, Apter A, Fainaru M . Parents as the exclusive agents of change in the treatment of childhood obesity. Am J Clin Nutr 1998; 67: 1130–1135.

    CAS  PubMed  Google Scholar 

  22. Nuutinen O, Knip M . Predictors of weight reduction in obese children. Eur J Clin Nutr 1992; 46: 785–794.

    CAS  PubMed  Google Scholar 

  23. Saelens BE, Ernst MM, Epstein LH . Maternal child feeding practices and obesity: a discordant sibling analysis. Int J Eat Disord 2000; 27: 459–463.

    CAS  PubMed  Google Scholar 

  24. Favaro A, Santonastaso P . Effects of parents psychological characteristics and eating behaviour on childhood obesity and dietary compliance. J Psychosomat Res 1995; 39: 145–151.

    CAS  Google Scholar 

  25. Fogelholm M, Nuutinen O, Pasanen M, Myohanen E, Saatela T . Parent–child relationship of physical activity patterns and obesity. Int J Obes Relat Metab Disord 1999; 23: 1262–1268.

    CAS  PubMed  Google Scholar 

  26. McGowan MJ, Harrington KE, Kiely M, Robson PJ, Livingstone MB, Gibney MJ . An evaluation of energy intakes and the ratio of energy intake to estimated basal metabolic rate (EI/BMRest) in the North/South Ireland Food Consumption Survey. Public Health Nutr 2001; 4: 1043–1050.

    CAS  PubMed  Google Scholar 

  27. Baranowski T, Domel SB . A cognitive model of children's reporting of food intake. Am J Clin Nutr 1994; 59 (Suppl 1): 212S–217S.

    CAS  PubMed  Google Scholar 

  28. Gortmaker SL, Must A, Perrin JM, Sobol AM, Dietz WH . Social and economic consequences of overweight in adolescence and young adulthood. N Engl J Med 1993; 329: 1008–1012.

    CAS  PubMed  Google Scholar 

  29. Fontaine KR, Cheskin LJ . Self-efficacy, attendance, and weight loss in obesity treatment. Addict Behav 1997; 22: 567–570.

    CAS  PubMed  Google Scholar 

  30. Karlsson J, Hallgren P, Kral J, Lindroos AK, Sjostrom L, Sullivan M . Predictors and effects of long-term dieting on mental well-being and weight loss in obese women. Appetite 1994; 23: 15–26.

    CAS  PubMed  Google Scholar 

  31. Johnson WG, Hinkle LK, Carr RE, Anderson DA, Lemmon CR, Engler LB, Bergeron KC . Dietary and exercise interventions for juvenile obesity: long-term effect of behavioral and public health models. Obes Res 1997;5:257–261.

    CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Vestische Kinderklinik Datteln, University of Witten-Herdecke, Datteln, Germany

    T Reinehr, K Brylak & W Andler

  2. Research Institute of Child Nutrition, Dortmund, Germany

    U Alexy & M Kersting

Authors
  1. T Reinehr
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. K Brylak
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. U Alexy
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. M Kersting
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. W Andler
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to T Reinehr.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Reinehr, T., Brylak, K., Alexy, U. et al. Predictors to success in outpatient training in obese children and adolescents. Int J Obes 27, 1087–1092 (2003). https://doi.org/10.1038/sj.ijo.0802368

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/sj.ijo.0802368

Keywords

This article is cited by

Search

Advanced search

Quick links