Prevalence of Overweight and Obesity Among US Children, Adolescents, and Adults, 1999-2002

Hedley, Allison

doi:10.1001/jama.291.23.2847

Cited by 3,876 publications

(2,556 citation statements)

References 7 publications

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“…Currently, close to 60% of the population of the US, the UK and Australia are classified by the World Health Organisation as overweight, and almost a third of these people suffer from obesity and related comorbidities. [1][2][3] The health costs relating to obesity in the developed world are expected to exceed that of tobacco smoking in the near future, 3 prompting much interest in the efficacy, sustainability and safety of weight loss interventions.…”

Section: Introductionmentioning

confidence: 99%

Changes in fat-free mass during significant weight loss: a systematic review

2006

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Objective: To identify the proportion of weight lost as fat-free mass (FFM) by various weight loss interventions. Methods: Medline and Embase were systematically searched for reliable measurements of FFM before and after weight loss of 410 kg and eligible data were pooled. In a fixed effect model of % FFM loss/weight loss (%FFML), linear regression analysis was used to determine the influence of degree of caloric restriction, exercise, magnitude of weight loss, initial body mass index (BMI) and type of surgery. Results: Data were included from 26 cohorts treated with dietary and behavioral interventions and 29 cohorts of bariatric surgery patients. The degree of caloric restriction was positively associated with %FFML (r 2 ¼ 0.31, P ¼ 0.006) and in three randomized controlled trials exercise was shown to decrease %FFML. Compared with laparoscopic adjustable gastric banding (LAGB), biliopancreatic diversion (BPD) and roux en Y gastric bypass (RYGB) caused greater log e (natural log) %FFML (r 2 ¼ 0.453, Po0.001). Differences in log e %FFML between surgical procedures were independent of initial BMI and magnitude of weight loss. Conclusions: The degree of caloric restriction, exercise and rate of weight loss influence the proportion of weight lost as FFM after non-surgical interventions. For surgical interventions, BPD and RYGB result in greater %FFML than LAGB.

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Section: Introductionmentioning

confidence: 99%

Changes in fat-free mass during significant weight loss: a systematic review

2006

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“…[1][2][3] Obesity affects both somatic and psychosocial health, and at childhood in particular, the first consequences are psychosocial. 4 Obese children are stigmatized, 4 and even modestly overweight children have decreased health-related quality of life.…”

Section: Introductionmentioning

confidence: 99%

Clinical efficacy of group-based treatment for childhood obesity compared with routinely given individual counseling

2007

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Objective: The aim of the study was to compare the efficacy of group treatment stressing a health-promoting lifestyle with routine counseling in the treatment of childhood obesity. Design and subjects: Seventy obese children (weight for height 115-182%) aged 7-9 years were randomized either to routine counseling (two appointments for children) or to family-based group treatment (15 separate sessions for parents and children). These sessions included nutrition education, physical activity education and behavioral therapy. Outcome measures: Children's weights and heights were measured at baseline, after the 6-month intervention and after the 6-month follow-up. The change of weight for height based on Finnish growth charts was used as the primary, and changes in body mass index (BMI) and BMI standard deviation scores (BMI-SDS) as secondary outcome measures. Results: Children attending the group treatment lost more weight for height (6.8%) than children receiving routine counseling (1.8%) (P ¼ 0.001). The difference was significant when the data were analyzed in four groups by the cut-off limits of 0, À5 and À10% for the change in weight for height. The respective decreases in BMI were 0.8 vs 0.0 (P ¼ 0.003) and in BMI-SDS 0.3 vs 0.2 (P ¼ 0.022). The results remained similar in adjusted analyses. Both group and routine programs were feasible with a high, 87-99%, participation rate in sessions and appointments and very low, 3% or less, attrition rate from the programs. Six months after the intervention, beneficial effects were partly lost, but for changes in weight for height and BMI, the differences between the two treatment programs still were significant, and for BMI-SDS, there was a trend. Conclusions: Family-based group treatment that stresses a health-promoting lifestyle and is given separately for parents and children, offers an effective mode of therapy to treat obese school-aged children.

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“…2 Obesity is increasing worldwide, reaching epidemic proportions. 3 Among children and adolescents, the prevalence of obesity is estimated to be about 20-25%. 4 Obesity is associated with increased risk of morbidity and with psychosocial consequences.…”

Section: Introductionmentioning

confidence: 99%

Health-related quality of life among children and adolescents: associations with obesity

et al. 2005

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Objective: To assess the impact of obesity on health-related quality of life (HRQOL) of children, and to compare HRQOL scores of obese children in a hospital versus community setting. Design: A cross-sectional study in two clinical samples. Subjects: A total of 182 children and adolescents recruited from the community pediatric clinics and a hospital-based obesity clinic. Measurements: Obesity was defined as body mass index (BMI) 495th percentile for age and gender. Subjects were divided into quartiles of BMI Z-scores each containing 45 or 46 children. The first two quartiles correspond to normal BMI, 3rd and 4th quartiles represent moderate and severe obesity, respectively. HRQOL was assessed by the Pediatric Quality of Life Inventoryt (PedsQLt) questionnaire submitted by both children and their parents. Results: Obese children reported significantly lower HRQOL in physical, social and school domains compared with normal weight children (Po0.01). Analyzing results of HRQOL by BMI quartiles showed that the emotional and school domains scores of the moderately obese children were similar to the normal BMI quartiles. Only in the 4th quartile, that of children with severe obesity, were scores significantly lower. In contrast, in both physical and social domains scores decreased progressively with increased BMI Z-scores. In the obese group, parents' scores were lower than the children's in all domains. HRQOL scores of obese children assessed in the hospital clinic were similar to that of obese children assessed in the community. Conclusions: Moderately obese children had similar emotional and school HRQOL scores as normal weight children, whereas in the physical domain, a significant difference was documented even in moderate obesity. Parents of obese children perceived their child's HRQOL lower than the children themselves. We believe that intervention programs aimed at improving HRQOL should be directed to both parents and children. Understanding the resilience of moderately obese children in school and emotional domains may assist us in the management of childhood obesity.

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Prevalence of Overweight and Obesity Among US Children, Adolescents, and Adults, 1999-2002

Cited by 3,876 publications

References 7 publications

Changes in fat-free mass during significant weight loss: a systematic review

Changes in fat-free mass during significant weight loss: a systematic review

Clinical efficacy of group-based treatment for childhood obesity compared with routinely given individual counseling

Health-related quality of life among children and adolescents: associations with obesity

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