Weight loss and growth velocity in obese children after very low calorie diet, exercise, and behavior modification

The prevalence of obesity in American youth is increasing and treatment of the condition is difficult. We have developed a multi-disciplinary weight reduction program that extends over 1 y and includes a very low-calorie diet (VLCD) followed by a hypocaloric diet, exercise, and behavior modification. Based on data collected at baseline, at the end of the acute intervention phase (10-20 wk), and at 1-y evaluation, we assessed the efficacy of this outpatient weight reduction program in treating obese children and adolescents in a follow-up of a series of cases. Furthermore, we examined the impact of the approach on growth velocity and maintenance of weight loss at 1 y. Fifty-six overweight children (aged 7-17 y) were recruited during a period of 18 mo to participate in the weight management program; 52 (93%) completed the acute phase of treatment and 35 (62.5%) successfully completed the 1-y program. There was a significant decrease in body weight and body fat, as assessed by weight determinations and skinfold measurements (p < 0.0001; results not corrected for age). The body mass index for the 35 individuals who completed the 1-y program decreased significantly from 32.7 on entry to 28.72 at 1 y (p < 0.0001; results not corrected for age). Conclusion: We conclude that a multidiscipinary weight reduction program that combines a VLCD, followed by a balanced hypocaloric diet, with a moderate-intensity progressive exercise program and behavior modification is an effective means for weight reduction in obese children and adolescents.