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Children with obesity

Primary care offers good prognosis for children with obesity

The study included 64 children aged eight to 13 who received treatment for obesity in primary or outpatient care clinics in their home area following a referral by the school health services

Children treated for obesity in primary or outpatient care have a relatively good chance of fending off weight problems over the next few years as well, according to researchers from Sahlgrenska Academy, University of Gothenburg, Sweden. The study found that after four years, there was no difference in outcome between the treatment options.

"There's an attitude that obesity is so terribly difficult to get rid of that you have to send the child to a specialist clinic, sometimes many tens of kilometers away,” said Staffan Mårild, Associate Professor of Pediatrics at Sahlgrenska Academy, University of Gothenburg, Sweden, and a paediatrician at Sahlgrenska University Hospital. “But the skills are often available closer at hand, and then there's a greater chance of the treatment taking place,"

The paper, ‘Four-year outcome of randomly assigned lifestyle treatments in primary care of children with obesity’, published in Acta Paediatrica, sought to assess the four‐year outcome in children with obesity randomised to one of two 12‐month lifestyle treatment programmes in primary care.

The study included 64 children aged eight to 13 who received treatment for obesity in primary or outpatient care clinics in their home area following a referral by the school health services. They were randomised to a treatment programme managed either by a nurse, dietician and physiotherapist (n=32) or by a nurse and dietician (n=32). The participating health centres were in Alingsås, Gothenburg, Skövde, and Vänersborg. The programme undergone by the children and their legal guardians included one year's regular advice on diet, physical activity, and sleep.

The follow-up included 56 of the 64 children and the results show that approximately three in 10 children were in a lower weight category than before. Thus, they had gone from severe obesity to obesity, from obesity to overweight, or from obesity or overweight to normal weight.

"It's not as if the study's weight results are all that impressive,” added Mårild. “However, they're at about the same levels as those achieved by the major research clinics. A big advantage here is that the effects persist after four years."

Mårild explained that the advantages of primary care are its simplicity and proximity to their home mean that more of them are reachable, while also reducing the risk of treatment interruptions.

"I think paediatric clinics and general medical centres should venture to take on these cases to a greater extent. Then, if it doesn't work, the children can be sent elsewhere in a second phase."

The researchers also noted that the treatment groups combined the number of children with obesity and their adiposity measures were significantly lower.

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