Zohar Landau1, Shirli Abiri2, Yael Lebenthal3, Daniela Jakubowicz4, Naomi Mor5, Liat Lerner-Geva6, Mona Boaz7, Julio Wainstein4, Yosefa Bar-Dayan8. 1. Pediatric Endocrinology Unit, Wolfson Medical Center, Holon, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. 2. Pediatric Endocrinology Unit, Wolfson Medical Center, Holon, Israel. 3. Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. 4. Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Diabetes Unit, Wolfson Medical Center, Holon, Israel. 5. Diabetes Unit, Wolfson Medical Center, Holon, Israel. 6. Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Gertner Institute for Epidemiology and Health Policy Research, Women and Children's Health Research, Tel Hashomer, Israel. 7. Epidemiology and Research Unit, E. Wolfson Medical Center, Holon, Israel. 8. Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Diabetes Unit, Wolfson Medical Center, Holon, Israel. Electronic address: bardayan@netvision.net.il.
Abstract
BACKGROUND: Lifestyle weight loss interventions represent the mainstay of treating children with obesity. Long-term follow-up studies of intervention programs are scarce. This study assessed the long-term effects and identified factors associated with significant weight loss. METHODS: This prospective, observational study involved 165 children with body mass index (BMI) z-score ≥1.5 who participated in after-school intervention program. MAIN OUTCOME MEASURE: change in BMI z-scores; decreased BMI z-score ≥0.5 units was defined as clinically significant. RESULTS: At baseline, 55/165 (33.3%) had BMI z-score 1.5-2 and 98 (59.4%) had BMI z-score >2. At follow-up (mean 5.4±1.4 years), 80 (48.5%) had a clinically significant reduction in BMI z-score, while 56 (33.9%) reported a mildly decrease in BMI z-score of 0-0.5 and 29 (17.6%) reported increased BMI z-score. Lower BMI z-score at baseline and participation in sport activity at follow-up were associated with long-term decrease in BMI z-score. Participation in additional post-intervention weight control programs was correlated with weight gain. CONCLUSIONS: Intervention program was associated with long-term improvement in weight control, especially in children with mild obesity. Physical activity was related to long-term success. Participation in an additional intervention program was associated with failure of weight control.
BACKGROUND: Lifestyle weight loss interventions represent the mainstay of treating children with obesity. Long-term follow-up studies of intervention programs are scarce. This study assessed the long-term effects and identified factors associated with significant weight loss. METHODS: This prospective, observational study involved 165 children with body mass index (BMI) z-score ≥1.5 who participated in after-school intervention program. MAIN OUTCOME MEASURE: change in BMI z-scores; decreased BMI z-score ≥0.5 units was defined as clinically significant. RESULTS: At baseline, 55/165 (33.3%) had BMI z-score 1.5-2 and 98 (59.4%) had BMI z-score >2. At follow-up (mean 5.4±1.4 years), 80 (48.5%) had a clinically significant reduction in BMI z-score, while 56 (33.9%) reported a mildly decrease in BMI z-score of 0-0.5 and 29 (17.6%) reported increased BMI z-score. Lower BMI z-score at baseline and participation in sport activity at follow-up were associated with long-term decrease in BMI z-score. Participation in additional post-intervention weight control programs was correlated with weight gain. CONCLUSIONS: Intervention program was associated with long-term improvement in weight control, especially in children with mild obesity. Physical activity was related to long-term success. Participation in an additional intervention program was associated with failure of weight control.