Paediatric obesity treatment had better outcomes when children were younger, well motivated and did not have acanthosis nigricans

Abstract

Aim: This study evaluated the efficacy of a paediatric obesity treatment programme and explored the factors that contributed to the outcome.

Methods: We recorded the body mass index standard deviation scores (BMI SDS) of 654 children aged 2-18 years who were treated for obesity in 2005-2012 in three Finnish hospitals, one year before treatment and up to three years after treatment. The family-based multidisciplinary treatment included nutritional advice, exercise and behavioural counselling. The BMI SDS changes, and their contributors, were explored with mixed-model and logistic regression analyses.

Results: BMI SDS increased before baseline and decreased at six, 12 and 24 months (all p < 0.001) and 36 months (p = 0.005). Younger age (p < 0.001), higher BMI SDS at baseline (p = 0.001), motivation (p = 0.013), adherence to the protocol (p = 0.033) and lack of acanthosis nigricans (p < 0.001) improved the outcome. The BMI SDS of children aged 2-6 decreased best from baseline to 12 (-0.35), 24 (-0.58) and 36 months (-0.64) (all p < 0.001).

Conclusion: Paediatric obesity treatment was most effective at a younger age. Good motivation and adherence contributed to favourable outcomes, while acanthosis nigricans was associated with a poor outcome.

Keywords: Acanthosis nigricans; Body mass index; Motivation; Outcome; Paediatric obesity treatment.