Changing Characteristics of Obese Children and Adolescents Entering Pediatric Lifestyle Intervention Programs in Germany over the Last 11 Years: An Adiposity Patients Registry Multicenter Analysis of 65,453 Children and Adolescents

• Published in: Obesity facts Vol. 10; no. 5; pp. 517 - 530
• Main Authors: Bohn, Barbara, Wiegand, Susanna, Kiess, Wieland, Reinehr, Thomas, Stachow, Rainer, Oepen, Johannes, Langhof, Helmut, Hermann, Thomas, Widhalm, Kurt, Wabitsch, Martin, Gellhaus, Ines, Holl, Reinhard
• Format: Journal Article
• Language: English
• Published: Basel, Switzerland S. Karger AG 2017; S. Karger GmbH; Karger Publishers
• Subjects: Adiposity - physiology; Adolescent; Adolescents; Age; Blood pressure; Body Mass Index; Body Weight; Calendars; Carbohydrates; Child; Children; Comorbidities; Comorbidity; Diabetes; Documentation; Female; Germany - epidemiology; Health insurance; Humans; Hypertension; Inpatient care; Life Style; Lifestyle intervention; Male; Metabolic disorders; Metabolism; Obesity; Original; Original Article; Outpatient care; Overweight; Overweight - epidemiology; Overweight - therapy; Pediatric Obesity - epidemiology; Pediatric Obesity - therapy; Pediatrics; Pension funds; Population; Registries; Regression analysis; Rehabilitation; Risk Reduction Behavior; Sociodemographics; Statistical analysis; Teenagers; Time trends; Trends; Values; Variables; Weight control; Weight Reduction Programs - statistics & numerical data; Switzerland; Austria; Germany; Obesity; Comorbidities; Lifestyle intervention; Outpatient care; Time trends; Inpatient care; Children; Adolescents
• ISSN: 1662-4025; 1662-4033; 1662-4033
• DOI: 10.1159/000479631

Objective: To examine whether characteristics of children and adolescents who start lifestyle intervention (LI) for obesity in Germany changed over the last decade. Methods: 65,453 subjects (<21 years) from the APV database (Adiposity Patients Registry) with a BMI ≥ 90th percentile were included (years 2005-2015). Logistic regression models (confounders: age, sex, migration background) were created for overweight, obesity, extreme obesity, and obesity-related comorbidities. Comorbidities were further adjusted for weight category. Results were stratified by inpatient or outpatient care. Results: Extreme obesity was found to be more frequent at the onset of LI (2005: 11.6; 2015: 12.7%) with a similar trend in subgroups (p < 0.001). Obesity increased (2005: 50.3%; 2015: 55.1%), and overweight decreased (2005: 34.1%; 2015: 29.0%) in the whole study population. Trends were similar for inpatient or outpatient care (all p < 0.001). Hypertension increased from 45.7% to 49.2% in the whole study population, and similar data were obtained in the subgroup of inpatients (both p < 0.0001). Dyslipidemia increased in all patients (2005: 21.9%; 2015: 28.0%) and in inpatients (2005: 20.2%; 2015: 25.7%; both p < 0.0001). Abnormal carbohydrate metabolism rose in all patients (from 5.2 to 6.4%; p = 0.0002) without significant trends in subgroups. Conclusion: During the last decade, children and adolescents presented with higher BMI SDS at the onset of LI and the proportion with obesity-related comorbidities increased. Particularly the presence of comorbidities differed between outpatients and inpatients.