Comparison of a Telehealth-Based Intensive Treatment Program with a Rewarding App vs. On-Site Care for Youth with Obesity: A Historical Cohort Study

Abstract

The recommended treatment for children with obesity includes numerous consultations by a multidisciplinary team, which is very cumbersome. Telehealth can assist in administering frequent care to children with obesity, yet the exact approaches and modes of delivery are still explored. During the COVID-19 pandemic, we developed an intensive telehealth-based treatment program that included a rewarding app for children with obesity. The aim of this study was to compare 6-month changes in body mass index (BMI) and body fat percent between participants in the program (n = 70) vs. children that underwent historic on-site care (n = 87). After 6 months, more participants in the telehealth group continued treatment compared to the on-site group (79% vs. 60%, p < 0.001). A significant reduction in the median BMI z-score (zBMI) was seen after 6 months in both groups (p < 0.01), with a similar proportion of zBMI reductions (71% in the telehealth group, 75% in the comparison group, p = 0.76). No statistically significant differences were found between the study groups in 6-month changes in BMI, zBMI, body fat percent or fat z-scores. We conclude that our telehealth program, which was executed during the COVID pandemic, resulted in a high proportion of children with zBMI reduction that was comparable with the more personal on-site care.

Lessons Learned from Telemedicine in Adolescent Obesity: Results of a Pilot Study

“…Studies conducted on children have concluded that online exercise programs [36] or exergaming [37] are more effective than only monitoring tools. A recent study performed over six months also showed no significant effect on fat percentage in telehealth and on-site groups [38]. To improve both body composition and fitness, innovative physical activity options are sought to promote energy expenditure in individuals with obesity.…”

“…It has been established that at least 26 contact hours are required to improve weight status in children with obesity, regardless of the mode of delivery [49]. However, Sela Peremen et al found that the group with online support had a higher rate of adherence (up to 25%) to the program [38].…”

“…Few studies have demonstrated a significant impact of telemedicine on serum cardiometabolic risk factors [53]. One study by Sela Peremen et al reported a statistically significant change in haemoglobin A1c after a 6-month telehealth-based treatment program for children with obesity [38]. Another study that lasted 24 weeks, which provided exergaming and fitness coaching, improved systolic and diastolic blood pressure, total cholesterol, and low-density lipoprotein cholesterol in the intervention group [37].…”