Predictors to success in outpatient training in obese children and adolescents.

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.