No abstract

Background: Internet-based treatments have proven effective for various health issues. There is a need to scale up interventions targeting children with obesity, also in less densely populated areas where the prevalence in many countries is higher than in urban areas. The aim of this study was to design and implement an internetbased program as an add-on to standard treatment for childhood obesity. Methods: Web-Childhood Obesity Prevention (Web-COP) was a prospective feasibility study with a pre-post-design. The intervention consisted of four groupbased education sessions at the clinic, physical activity on prescription, and a new 12-week internet-based program. Web-COP was offered to children with obesity (International Obesity Task Force Body Mass Index (IOTF-BMI) ≥ 30 kg/m2) and their parents in two counties in Northern Sweden from August 2018 to June 2019. The primary outcome was change in BMI standard deviation score (BMI-SDS). Results: The study included 55 children 5-13 years of age. The internet-based component was well received, and retention rate was 51/55 (92.7%). Data was analysed for 51 children. Mean BMI-SDS was 3.3 at start and decreased by 0.2, 0.3, and 0.4 at two, four, and six months from baseline. Using a continuous algorithm, 42/51 (81%), children lowered their BMI-SDS and 33/51 (65%) lowered their BMI. Conclusion: Adding group sessions and an internet-based program to standard care was feasible and two thirds of included children with obesity reduced their BMI.

The prevalence of childhood overweight and obesity is rising at an alarming rate, and the World Health Organization (WHO) estimated in 2016 that more than 330 million school-age children and teenagers are affected worldwide. 1,2 In Sweden, about 17% of children 6-9 years old have overweight, and another 5%-6% have obesity. 3 Children with obesity have an increased risk of remaining obese as adults with several health consequences, such as heart disease, hypertension, type 2 diabetes, fatty liver disease, cancer and increased risk of social and psychological problems. 4,5 Therefore, prevention and treatment of obesity in children are essential to improve health and avoid obesity-related complications later in life. 6