Verlauf von Übergewicht und Adipositas nach einer Lifestyleintervention im Kindes- und Jugendalter - Prädiktoren für den Langzeiterfolg

Introduction: Outpatient lifestyle interventions with a multimodal, interdisciplinary approach are established therapies for children and adolescents with overweight or obesity. The data regarding their effect sizes is weak. There are studies on short-term effects (<1 year) of intervention programs, but there is a research gap for long-term proof of effectiveness (> 1 year). There is a need to detect predictors of the characteristics of the participant and his fam-ily for long-term therapeutic success and weight development after the end of treatment. Method: The one-year "Fit Kids" intervention involved 190 children and adolescents (87 girls / 103 boys, 7-15 years, ≥ 90. BMI sds age percentiles). At the beginning of the intervention the anthropometric data BMI / BMI-sds, the psychosocial wellbeing, the quality of life of the participant, a family adversity index, the family burden with obesity as well as maternal depression and attachment were examined. The participant-related characteristics were meas-ured at the end of the intervention, the anthropometric data of the participants two years after the end of intervention and all participant-related characteristics four years after the end of the intervention. Results: The correlations with the successful long-term BMI sds reduction (1st success crite-rion) were the BMI sds at the end of the intervention (p <0.05), the successful (BMI sds re-duction> 5%) Participation in the intervention (p <0.00), the depression of the participant after intervention and the occupation of the mother (p <0.05) and the education of the father (p <0.1) associated. The BMI sds at the end of intervention was the best predictor in regres-sion analysis for long-term success (BMI sds reduction> 5%) (p <0.05). With the weight de-velopment after the end of treatment (2nd success criterion) the BMI sds at the start of the intervention (p <0.05), the participant's depression after intervention (p <0.05), the BMI of father (p <0.1) and mother (p <0.05) in addition to a fearful attachment of the mother (p <0.1) were associated. The best predictor in the regression analysis was the mother's BMI at baseline (p <0.05). Discussion: For long-term successful treatment of overweight and obesity in childhood and adolescence, in addition to the therapeutic success under intervention, the weight of the mother and the depression of the participant at the end of the intervention are decisive. Struc-tural concepts for appropriately stressed participants should be developed to increase the suc-cess rate for these children.