Publikationsserver der Universitätsbibliothek Marburg
Titel:Verlauf von Übergewicht und Adipositas nach einer Lifestyleintervention im Kindes- und Jugendalter - Prädiktoren für den Langzeiterfolg
Autor:Stüber, Johannes
Weitere Beteiligte: Pauli-Pott, Ursula (Prof. Dr., Dipl.-Psych.)
Veröffentlicht:2018
URI:https://archiv.ub.uni-marburg.de/diss/z2018/0182
DOI: https://doi.org/10.17192/z2018.0182
URN: urn:nbn:de:hebis:04-z2018-01826
DDC: Medizin
Titel (trans.):Course of overweight and obesity after a lifestyle intervention in childhood and adolescence - predictors of long-term success
Publikationsdatum:2018-02-28
Lizenz:https://creativecommons.org/licenses/by-nc-sa/4.0

Dokument

Schlagwörter:
Therapie, ambulante Lifestyleintervention, Adipositas, Prädiktoren, Übergewicht, Obesity, Langzeiterfolg, Jugendliche, long-term sucess, adolescents, Kinder, children, predictors, outpatient lifestyle intervention, therapy

Zusammenfassung:
Einleitung: Ambulante Lifestyleinterventionen mit einem multimodalen, interdisziplinären Konzept sind etablierte Therapieangebote für Kinder und Jugendliche mit Übergewicht oder Adipositas. Die Datenlage bezüglich deren Effektstärken ist schwach. Für kurzfristige Effek-te (< 1 Jahr) ambulanter Interventionsprogramme gibt es Studien, jedoch besteht eine For-schungslücke für den langfristigen Effektivitätsnachweis (> 1 Jahr). Dazu sollten für den langfristigen Therapieerfolg und die Gewichtsentwicklung nach Therapieende Prädiktoren unter den Merkmalen des Teilnehmers und seiner Familie eruiert werden. Methode: An der einjährigen Intervention „Fit Kids“ nahmen 190 Kinder und Jugendliche (87 Mädchen / 103 Jungen; 7 - 15 Jahre; ≥ 90. BMI-sds-Altersperzentile) teil. Zu Interventi-onsbeginn wurden die anthropometrischen Daten BMI/BMI-sds, das psychosoziale Wohlbe-finden, die Lebensqualität des Teilnehmers, ein Family Adversity Index, die familiäre Belas-tung mit Übergewicht sowie die mütterliche Depressivität und Bindungseinstellung unter-sucht. Die teilnehmerbezogenen Merkmale wurden am Ende der Intervention, die anthropo-metrischen Daten der Teilnehmer zudem zwei Jahren nach Interventionsende und alle teil-nehmerbezogenen Merkmale vier Jahre nach Interventionsende gemessen. Ergebnisse: Bei den Korrelationen mit der erfolgreichen langfristigen BMI-sds-Reduktion (1. Erfolgskriterium) waren der BMI-sds am Ende der Intervention (p < 0,05), die erfolgrei-che (BMI-sds-Reduktion > 5 %) Teilnahme an der Intervention (p < 0,00), die Depressivität des Teilnehmers nach Intervention und die Berufstätigkeit der Mutter (p < 0,05) sowie die Schulbildung des Vaters (p < 0,1) assoziiert. Der BMI-sds bei Interventionsende war für den langfristigen Erfolg (BMI-sds-Reduktion > 5 %) der beste Prädiktor in der Regressionsanaly-se (p < 0,05). Mit der Gewichtsentwicklung nach Therapieende (2. Erfolgskriterium) waren der BMI-sds bei Interventionsbeginn (p < 0,05), die Depressivität des Teilnehmers nach In-tervention (p < 0,05), der BMI von Vater (p < 0,1) und Mutter (p < 0,05) neben einer ängstli-chen Bindungseinstellung der Mutter (p < 0,1) assoziiert. Bester Prädiktor in der Regressi-onsanalyse war der BMI der Mutter bei Interventionsbeginn (p < 0,05). Diskussion: Für eine langfristig erfolgreiche Therapie von Übergewicht und Adipositas in Kindheit und Jugend sind neben dem Therapieerfolg unter Intervention, das Gewicht der Mutter und die Depressivität des Teilnehmers bei Interventionsende ausschlaggebend. Sollte es hier gelingen strukturelle Konzepte für entsprechend belastete Teilnehmer zu entwickeln, kann die Erfolgsquote für diese Kinder möglicherweise gesteigert werden.

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