Page 124 - Go4it
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Chapter 8
 General discussion Introduction
This thesis describes the effectiveness of a multidisciplinary group treatment Go4it in obese adolescents (11-18 years). Go4it aims to prevent the development of diabetes mellitus type 2 by improving dietary behaviour, physical activity and sedentary behaviour among obese adolescents. This chapter summarizes the study results that are presented in this thesis. In addition, the results and methodological considerations will be discussed, and future recommendations for research and clinical practice will be provided.
Summary of main findings
Effectiveness of Go4it
At 18 months follow-up, the Go4it group had a mean decrease of 2 kg in comparison with the control group. None of the other body composition or metabolic components showed significant treatment effects. Western adolescents benefited most from Go4it, besides BMIsds also Systolic BP, Diastolic BP and HDL improved significantly at 18 months follow-up. Among adolescents who complied well (attended ≥ 5 of the 7 Go4it sessions) a significant intervention effect on BMIsds, waist circumference and HDL was found at 18 months follow-up (Chapter 3). In addition small but beneficial intervention effects on quality of life (assessed by PedsQLTM4.0 and BES) were found. Two subscales of the PedsQLTM4.0, namely physical health and school functioning, improved significantly in favour of the intervention group (Chapter 4).
Compliance
Compliance was a big challenge. Of the adolescents assigned to the intervention group, 59% attended at least 5 of the 7 Go4it sessions. Reasons for not attending the Go4it sessions included: lack of motivation to change dietary habits, lack of belief of parents in their child’s possible success to lose weight, previous unsuccessful dieting experiences, travel distance and the limited time of working parents and schoolchildren. Seventy-two percent of the parents attended the first parent session and 55% the second. The control group received regular care, which was referral to a dietician. At 6 months follow-up 48% of the control group had never visited a dietician, n=4 visited a dietician once, n=6 went twice, n=7 went 3 or more times, and for 6 participants it is unknown. The main reason for noncompliance was lack of motivation because of previous unsuccessful dieting experiences with or without a dietician (Chapter 3).
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