A hospital-based child and adolescent overweight and obesity treatment protocol transferred into a community healthcare setting

PLoS One. 2017 Mar 6;12(3):e0173033. doi: 10.1371/journal.pone.0173033. eCollection 2017.

Abstract

Background: Due to the pandemic of child and adolescent overweight and obesity, improvements in overweight and obesity treatment availability and accessibility are needed.

Methods: In this prospective study, we investigated if reductions in body mass index (BMI) standard deviation scores (SDS) and waist circumference (WC) would occur during 1.5 years of community-based overweight and obesity treatment based upon an effective hospital-based overweight and obesity treatment protocol, The Children's Obesity Clinics' Treatment protocol. Height, weight, and WC were measured at all consultations. Changes in BMI SDS and WC were analyzed using linear mixed models based upon the repeated measures in each child.

Results: From June 2012 to January 2015, 1,001 children (455 boys) were consecutively enrolled in the community-based treatment program. Upon entry, the median age was 11 years (range: 3-18), and the median BMI SDS was 2.85 (range: 1.26-8.96) in boys and 2.48 (range: 1.08-4.41) in girls. After 1.5 years of treatment BMI SDS was reduced in 74% of the children. BMI SDS was reduced by a mean of 0.38 (95% confidence interval (CI): 0.30-0.45, p<0.0001) in boys and 0.18 (95% CI: 0.12-0.25, p<0.0001) in girls after 1.5 years of treatment, independently of baseline age, BMI SDS, and Tanner stage (all p>0.08). WC was reduced by a mean of 3.8 cm (95% CI: 2.7-4.9, p>0.0001) in boys and 5.1 cm (95% CI: 4.0-6.2, p>0.0001) in girls. The dropout rate was 31% after 1.5 years. A median of 4.5 consultation hours was invested per child per year.

Conclusion: BMI SDS and WC were reduced after 1.5 years of treatment. Hence, this community-based overweight and obesity treatment program may help accommodate the need for improvements in treatment availability and accessibility.

MeSH terms

  • Adolescent
  • Body Mass Index
  • Body Weights and Measures
  • Child
  • Child, Preschool
  • Community Health Services*
  • Denmark / epidemiology
  • Denmark / ethnology
  • Female
  • Humans
  • Male
  • Obesity / diagnosis
  • Obesity / epidemiology*
  • Obesity / therapy*
  • Overweight / diagnosis
  • Overweight / epidemiology*
  • Overweight / therapy*
  • Socioeconomic Factors
  • Time Factors
  • Treatment Outcome

Grants and funding

The study was funded by the Region of Zealand, the Region Zealand Health Scientific Research Foundation, and the Aase and Ejnar Danielsen’s Foundation. The study was a part of the research project “The Danish Childhood Obesity Biobank” (ClinicalTrials.gov ID-no.: NCT00928473) conducted in collaboration with the TARGET (The Impact of our Genomes on Individual Treatment Response in Obese Children, www.target.ku.dk) and BIOCHILD (Genetics and Systems Biology of Childhood Obesity in India and Denmark, www.biochild.ku.dk) consortia, which are funded by grants from the Innovation Fund Denmark (0603-00484B and 0603-00457B), The Novo Nordisk Foundation (NNF15OC0016544) and the Region Zealand Health Scientific Research Foundation. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.