Long-term effect of the Go4it group treatment for obese adolescents: A randomised controlled trial

• Published in: Clinical nutrition (Edinburgh, Scotland) Vol. 33; no. 3; pp. 385 - 391
• Main Authors: Hofsteenge, G.H, Chinapaw, M.J.M, Delemarre-van de Waal, H.A, Weijs, P.J.M
• Format: Journal Article
• Language: English
• Published: Kidlington Elsevier Ltd 01.06.2014; Elsevier
• Subjects: Adolescent; Adolescents; Anthropometrics; Biological and medical sciences; Blood Glucose - metabolism; Blood Pressure; Body Composition; Body Mass Index; Body Weight; Child; Cholesterol, HDL - blood; Feeding. Feeding behavior; Female; Follow-Up Studies; Fundamental and applied biological sciences. Psychology; Gastroenterology and Hepatology; Humans; Insulin - blood; Male; Medical sciences; Metabolic diseases; Metabolic factors; Multidisciplinary group treatment; Netherlands; Obese; Obesity; Obesity - therapy; Treatment Outcome; Triglycerides - blood; Vertebrates: anatomy and physiology, studies on body, several organs or systems; Weight Reduction Programs; Netherlands; Multidisciplinary group treatment; Obese; Metabolic factors; Adolescents; Anthropometrics; Body composition; Human; Obesity; Randomization; Treatment; Nutrition disorder; Adolescent; Clinical trial; Metabolic diseases; Long term; Nutritional status
• ISSN: 0261-5614; 1532-1983
• DOI: 10.1016/j.clnu.2013.06.002

Summary Background & aims Few studies evaluating treatment of adolescent obesity have been published. Therefore, long-term effects of the Go4it group treatment for obese adolescents were examined. Methods Obese adolescents (11–18 years) visiting an outpatient paediatric obesity clinic were randomly assigned to 1) intervention group (Go4it) or 2) current regular care i.e. referral to a dietician in the home care setting (controls). Linear mixed models analysis was performed to evaluate intervention effects. Effect modification by sex, age and ethnicity was checked. Outcome measures included body mass index standard deviation score (BMIsds), body composition and metabolic components at 6 and 18 months follow-up. Results 122 adolescents, 71 Go4it and 51 controls, with a mean BMIsds of 2.9 ± 0.5 were randomised. At 18 months a modest significant reduction in BMIsds ( between group difference : −0.16; 95%CI: −0.30, −0.02; p  = .028) was observed. None of the other body composition or metabolic components showed significant treatment effects. Ethnicity was a significant effect modifier. Posthoc analysis showed a large significant reduction on BMIsds ( between group difference:  −0.35; 95%CI: −0.64, −0.07) at 18 months for obese adolescents from western descent, while no effect was observed for adolescents from non-western descent. Significant treatment effects were also observed for systolic and diastolic blood pressure, as well as HDL cholesterol level, but only for obese adolescents from western descent. Conclusions Go4it showed promising long-term effects on BMIsds compared with regular care in obese adolescents. Larger benefits were achieved for adolescents of western ethnicity. This trial was registered at www.trialregister.nl with the Netherlands Trial Register as ISRCTN27626398.