Four-year follow-up of children and adolescents participating in an obesity intervention program.

BACKGROUND: Since obesity affects children's health and social integration, treatment concepts with long-term efficiency are necessary.

METHODS: We analyzed changes of standard deviation score of body mass index (SDS-BMI) quarterly in the first year and once a year during the next 3 years in all obese children participating in the 1-year outpatient intervention program 'Obeldicks', which was based on physical exercise, nutrition education and behavior therapy. All analyses were performed on the intention-to-treat approach.

RESULTS: One hundred and thirty-one children (77%) of the 170 children (mean age 10.5 years, 51% female, mean BMI 26.9 kg/m(2), mean SDS-BMI 2.54) attending the 'Obeldicks' intervention program reduced their overweight at the end of intervention (mean SDS-BMI reduction 0.41) and 122 (66%) 3 years after end of intervention (mean SDS-BMI reduction 0.48). The reduction of overweight was independent of the child's gender, age and parental age and BMI. Reduction of 0.33 SDS-BMI in the first 3 months was the best predictor for long-term success (95% predictive value).

CONCLUSIONS: Participating in the 1-year outpatient obesity intervention program 'Obeldicks' was associated with a decrease of overweight, which was sustained 3 years after the end of intervention. Reduction of overweight in the first 3 months of the intervention was highly predictive for long-term success.