[Clinical and metabolic effectiveness of a new motivational therapy for the treatment of obesity in adolescents (OBEMAT)]

Abstract

Introduction: The mainstay of the treatment of childhood obesity is the promotion of behavioural changes, which are especially difficult during adolescence. This paper proposes and evaluates a new motivation-based therapeutic protocol, structured in objectives, which is applicable from paediatric practice.

Patients and methods: A total of 110 obese adolescents were studied. The therapeutic protocol consisted of 12 monthly visits, in two phases: Motivational and Interventional, in which changes were proposed and objectives were agreed, and later evaluated taking into account the difficulties and achievements. Weight and height was measured in each visit, and blood pressure, waist circumference, glucose, insulin and lipid profile were measured at the beginning and at the end.

Results: There was a mean decrease of 0.5 SDS in BMI z-score in the adolescents who completed the intervention (78.2%), with this decrease being 0.8 SDS in the group of patients with good response to treatment (75.6%). This group had a significantly lower total cholesterol, LDL, triglycerides, insulin and HOMA index. The main predictor of good response was the success of the motivational phase, with a positive predictive value of 95% (83-98%).

Conclusions: BMI z-score decreases and the control of anthropometric and biochemical parameters, show that OBEMAT is a highly effective method compared to those published previously. The response to the motivational phase largely determines the success or failure of the intervention.