Smaller Weight Changes in Standardized Body Mass Index in Response to Treatment as Weight Classification Increases

Johnston, Craig A.; Tyler, Chermaine; Palcic, Jennette L.; Stansberry, Sandra A.; Gallagher, Martina R.; Foreyt, John P.

doi:10.1016/j.jpeds.2010.09.049

Cited by 65 publications

(72 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Most studies showed weight loss during the intensive treatment period, but weight gain during follow-up [46,47,48,49,50]. Two studies evaluated treatments including an inpatient period, similar to our study.…”

Section: Discussionsupporting

confidence: 78%

Economic Evaluation of Intensive Inpatient Treatments for Severely Obese Children and Adolescents

et al. 2017

View full text Add to dashboard Cite

Background: Considering the large economic consequences of severe childhood obesity for the society, we aimed to conduct an economic evaluation comparing two intensive 1-year lifestyle treatments with varying inpatient periods for severely obese children and adolescents with regard to standard deviation score BMI (SDS-BMI) and quality-adjusted life years (QALYs). Methods: An economic evaluation from a societal perspective accompanying a randomized controlled trial with a 24-month follow-up. 80 participants (8-19 years) with severe obesity were included. Participants received an intensive 1-year lifestyle treatment with an inpatient period of 2 months (short-stay group) or 6 months (long-stay group). Data were collected at baseline, 6, 12 ,and 24 months and included SDS-BMI and QALYs. Results: SDS-BMI decreased in the first 6 months of treatment, stabilized in the second 6 months, and increased during the 2nd year in both groups. After 24 months, SDS-BMI was similar in both groups, but remained lower than baseline values (mean difference -0.24, 95% CI -0.42; -0.06). There was no difference in QALYs between the groups after 24 months. For SDS-BMI, the probability of the short-stay treatment being cost-effective in comparison with the long-stay treatment was 1 at a willingness-to-pay of 0 EUR/unit of effect, which slowly decreased to 0.54 for larger willingness-to-pay values. Conclusions: Based on the results of this study, the short-stay treatment is considered to be more cost-effective from the societal perspective in comparison with the long-stay treatment. Future research should provide insight in whether the short-stay treatment is cost-effective in comparison with usual care.

show abstract

Section: Discussionsupporting

confidence: 78%

Economic Evaluation of Intensive Inpatient Treatments for Severely Obese Children and Adolescents

et al. 2017

View full text Add to dashboard Cite

show abstract

“…30,31,170,176 Levine et al 170 conducted a family-based behavioral treatment study in 24 children 8 to 12 years old with severe obesity (defined as ≥160% of ideal body weight; mean BMI, 34.5 kg/m 2 ) and demonstrated a BMI reduction of 1.7 kg/m 2 at a mean follow-up of ≈8 months. In a study of children (aged 8-12 years old) with severe obesity (defined as BMI ≥97th percentile) and mean baseline BMI at approximately the 99th percentile, Kalarchian et al 31 found that a 6-month comprehensive, family-based behavioral weight management intervention was associated with significantly reduced percent overweight and improved medical outcomes.…”

Section: Role Of Lifestyle Modification/behavioral Therapy In Severe mentioning

confidence: 99%

“…Thus, the benefits of treatment on weight were promising during the period of intensive intervention but were no longer present 1 year after the intervention ended. Another study conducted by Johnston et al 30 compared the weight loss response to lifestyle intervention in children and adolescents (aged 9-14 years old) in various BMI categories (overweight, obese, and severely obese, defined as BMI ≥99th percentile). The intervention focused on eating and physical activity behaviors and behavior modification strategies aimed at weight reduction.…”

Section: Role Of Lifestyle Modification/behavioral Therapy In Severe mentioning

confidence: 99%

“…[19][20][21][22][23][24][25][26][27][28][29] Unfortunately, many of the treatment approaches commonly used with some success in overweight and obese youth are less effective in those with severe obesity. [30][31][32][33] Novel treatment strategies tailored for severe obesity are therefore needed to alter the health trajectory of children and adolescents afflicted with this condition.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Severe Obesity in Children and Adolescents: Identification, Associated Health Risks, and Treatment Approaches

Kelly¹,

Barlow

Rao³

et al. 2013

Circulation

897

804

View full text Add to dashboard Cite

espite recent data suggesting that the rate of increase of obesity among children and adolescents has slowed and overall prevalence has possibly begun to plateau, 1,2 a worrisome trend has emerged in the form of severe pediatric obesity. As the fastest-growing subcategory of obesity in children and adolescents, 1,3,4 severe obesity afflicts between 4% and 6% of all youth in the United States 3-7 and has both immediate and long-term health consequences. Recent data further Abstract-Severe obesity afflicts between 4% and 6% of all youth in the United States, and the prevalence is increasing.Despite the serious immediate and long-term cardiovascular, metabolic, and other health consequences of severe pediatric obesity, current treatments are limited in effectiveness and lack widespread availability. Lifestyle modification/behaviorbased treatment interventions in youth with severe obesity have demonstrated modest improvement in body mass index status, but participants have generally remained severely obese and often regained weight after the conclusion of the treatment programs. The role of medical management is minimal, because only 1 medication is currently approved for the treatment of obesity in adolescents. Bariatric surgery has generally been effective in reducing body mass index and improving cardiovascular and metabolic risk factors; however, reports of long-term outcomes are few, many youth with severe obesity do not qualify for surgery, and access is limited by lack of insurance coverage. To begin to address these challenges, the purposes of this scientific statement are to (1) provide justification for and recommend a standardized definition of severe obesity in children and adolescents; (2) raise awareness of this serious and growing problem by summarizing the current literature in this area in terms of the epidemiology and trends, associated health risks (immediate and long-term), and challenges and shortcomings of currently available treatment options; and (3) highlight areas in need of future research. Innovative behavior-based treatment, minimally invasive procedures, and medications currently under development all need to be evaluated for their efficacy and safety in this group of patients with high medical and psychosocial risks. (Circulation. 2013;128:1689-1712.)

show abstract

“…Pediatric and adolescent extreme obesity are distinct from simple obesity as they are associated with high comorbidity rates and are resistant to lifestyle interventions [51]. Few weight loss drugs have been evaluated in children and adolescents and this is the first study to examine the effects of a glucagon-like peptide-1 receptor agonist in obese youth.…”

Section: Is There a Hope For New Drugs?mentioning

confidence: 99%

Obesity and Weight Regulation

Wabitsch¹,

Tews²,

Denzer³

et al. 2013

Yearbook of Pediatric Endocrinology 2013

View full text Add to dashboard Cite

We have been very happy to get 2,049 papers out of our established search strategy in PubMed, which have been saved in our 2013 Yearbook EndNote database. We then selected 22 papers which in our mind have been the most exciting ones. The highlights in this year's chapter are publications on the influence of sugar consumption on BMI development, new findings on the development, occurrence and function of brown adipose tissue in humans, recent findings on leptin deficiency and leptin resistance, and finally more insight into the possible role of bariatric surgery as a therapeutic option in adolescents with extreme obesity. Thus, the present Yearbook chapter on obesity and weight regulation covers again a broad research area with some new developments, which we think have the potential for a future breakthrough. New risk assessment of overweight and obesity Cardiovascular disease risk in healthy children and its association with body mass index: systematic review and meta-analysisFriedemann C, Heneghan C, Mahtani K, Thompson M, Perera R, Ward AM Department of Primary Care Health Sciences, University of Oxford, Oxford, UK Claire. Friedemann@phc.ox.ac.uk BMJ 2012;345:e4759 Background: Two thirds of the world's population live in countries where obesity-related illness is a significant cause of mortality. However, the effect of obesity on children is currently less well understood. Therefore, this analysis aimed to systematically review available evidence on the magnitude of the association between body mass index and cardiovascular risk in obese children and adolescents. Methods: Literature research included papers published between January 2000 and December 2011 indexed in PubMed, Embase, EBSCOhost's cumulative index to nursing and allied health literature, and the Web of Science databases. Studies were included in the review if they enrolled healthy children between 5 and 15 years from highly developed countries, were initiated after 1990, used retrospective, cross-sectional, case-control, or RCT study designs, and reported weight and at least one prespecified cardiovascular risk factor. For quality assessment of the systematic review, an adapted risk of bias tool of the Cochrane Collaboration was used.Results: Meta-analysis included 63 studies of 49,220 children from 23 countries. Systolic, diastolic and 24-hour ambulatory blood pressure was significantly higher in overweight or obese children compared to normal-weight children. Resting systolic pressure was higher in overweight and obese patients (overweight: 4.54 mm Hg; 99% CI 2.44; 6.64; p < 0.001; obese: 7.49 mm Hg; 99% CI 3.36; 11.62; p < 0.001) as well as diastolic (overweight: 2.57 mm Hg; 1.55; 3.58; p < 0.001; obese: 4.06 mm Hg; 2.05; 6.08; p < 0.001) compared to normal-weight peers. Similar associations were seen in 24-hour ambulatory systolic blood pressure. Obesity was associated with unfavorable serum lipid profiles characterized by elevated total cholesterol (TC) and triglyceride (Tg) levels (TC 0.15 mmol/l; 0.04; 0.25; p < 0.001; Tg 0.21 mmol/l; ...

show abstract

Smaller Weight Changes in Standardized Body Mass Index in Response to Treatment as Weight Classification Increases

Cited by 65 publications

References 29 publications

Economic Evaluation of Intensive Inpatient Treatments for Severely Obese Children and Adolescents

Economic Evaluation of Intensive Inpatient Treatments for Severely Obese Children and Adolescents

Severe Obesity in Children and Adolescents: Identification, Associated Health Risks, and Treatment Approaches

Obesity and Weight Regulation

Contact Info

Product

Resources

About