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Paediatric obesity treatment had better outcomes when children were younger, well motivated and did not have acanthosis nigricans
Author(s) -
Dalla Valle Marketta,
Laatikainen Tiina,
Lehikoinen Miika,
Nykänen Päivi,
Jääskeläinen Jarmo
Publication year - 2017
Publication title -
acta paediatrica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.772
H-Index - 115
eISSN - 1651-2227
pISSN - 0803-5253
DOI - 10.1111/apa.13953
Subject(s) - medicine , acanthosis nigricans , body mass index , obesity , pediatrics , childhood obesity , overweight , insulin resistance
Aim This study evaluated the efficacy of a paediatric obesity treatment programme and explored the factors that contributed to the outcome. Methods We recorded the body mass index standard deviation scores ( BMI SDS ) of 654 children aged 2‐18 years who were treated for obesity in 2005–2012 in three Finnish hospitals, one year before treatment and up to three years after treatment. The family‐based multidisciplinary treatment included nutritional advice, exercise and behavioural counselling. The BMI SDS changes, and their contributors, were explored with mixed‐model and logistic regression analyses. Results BMI SDS increased before baseline and decreased at six, 12 and 24 months (all p < 0.001) and 36 months (p = 0.005). Younger age (p < 0.001), higher BMI SDS at baseline (p = 0.001), motivation (p = 0.013), adherence to the protocol (p = 0.033) and lack of acanthosis nigricans (p < 0.001) improved the outcome. The BMI SDS of children aged 2–6 decreased best from baseline to 12 (−0.35), 24 (−0.58) and 36 months (−0.64) (all p < 0.001). Conclusion Paediatric obesity treatment was most effective at a younger age. Good motivation and adherence contributed to favourable outcomes, while acanthosis nigricans was associated with a poor outcome.