Background: The alarming rise in childhood obesity has resulted in a number of bariatric surgical initiatives. To interpret the outcomes, a comparison with a nonoperative approach is prudent.
Methods: In 2003, 2004, and 2005, we measured the outcomes produced by an isolated summer camp in North Carolina for 74, 99, and 89 obese children and adolescents with a mean age of 12.7 +/- 2.3, 13.0 +/- 1.9, and 13.2 +/- 1.8 years and initial body mass index (BMI) of 33.1 +/- 5.7, 33.4 +/- 6.4, and 32.9 +/- 7.0 kg/m2, respectively. The camp featured a 1700/d caloric diet, daily aerobic and resistance weight training exercise, nutrition classes, and weekly sessions with a psychologist. The changes in weight, BMI, body shape measurements, and fitness level were assessed. The average length of stay was 4.3, 4.2, and 4.4 weeks, respectively, in 2003, 2004, and 2005.
Results: The BMI, body shape, and weight change measures significantly improved during each of the summers. The campers lost 1.6, 2.0, and 1.8 kg/wk during each of the 3 years. Their waist measurements decreased by 9.1 +/- 5.12 cm, 9.9 +/- 5.6 cm, and 8.1 +/- 5.8 cm. Significant improvements occurred in the timed sprints, .5-mile (0.8-km) run, and vertical jump. Of those campers staying for two summers, 4.4% continued to reduce their BMI despite growth, 56.5% maintained their BMI at less than the initial baseline measurement, and 39.1% increased their BMI to greater than the baseline. The co-morbidities also improved. One camper, aged 15 years, weighing 211 kg, progressed from being able to walk 3 steps to managing the 100-yard (91-m) dash in 42 seconds after losing 35 kg in 8 weeks.
Conclusion: Diets, exercise, and behavioral modification are useful approaches in severely obese children that can, in some, produce significant albeit expensive long-term results. Recidivism is a problem. Surgical outcomes must compare favorably with these outcomes.