Behavioural treatment can be very effective for severely obese children

A new study from Karolinska Institutet in Sweden shows that behavioural treatment for inducing weight-loss can be very effective for severely obese children. However, the treatment to change dietary and exercise habits must be given in time, as it showed to have little effect on adolescents with the same problem.

"The results are indeed alarming for these severely obese adolescents, who run a serious risk of disease and social marginalisation," says Claude Marcus, professor of paediatrics at Karolinska Institutet. "New treatment methods must be developed and for some young people, surgery must even be considered an option."

In the present study, which is published in the scientific journal Archives of Pediatrics & Adolescent Medicine, the researchers have evaluated a form of behavioural treatment for seriously obese children centred on exercise and diet. Over a period of three years, the children met regularly with a team comprising a doctor, psychologist, physiotherapist, nurse and dietician at Rikscentrum Barnobesitas, a national childhood obesity centre based at the Astrid Lindgren Children's Hospital in Stockholm. The study included 643 obese children and adolescents in the 6 - 16 age-band, who began treatment between 1998 and 2006.

The results show that the behavioural treatment was effective for the younger children, particularly those with severe obesity. But the older the participants were, the harder it became to change their dietary and exercise habits. Teenagers with moderate obesity responded slightly to the treatment, but for the large majority of teenagers with severe obesity, it had no demonstrable health effect at all.

The study also revealed that most of the obese adolescents had weight problems already in primary school, leading the researchers to conclude that much would be gained if treatment was started when overweight or obese children were six or seven years old.

"Unfortunately, data from the Swedish national Childhood Obesity Registry, BORIS,  show that the average age for beginning treatment is currently ten," says team member Dr Pernilla Danielsson. "And there are some health authorities that offer no treatment at all to obese children."