Page 136 - Go4it

Summary
Go4it - The effectiveness of a multidisciplinary group treatment for outpatient obese adolescents
Overweight and obesity among children and adolescents in the Netherlands are increasing public health problems. The Fifth Dutch Growth Study shows that between 2008 and 2010 13% of Dutch children were overweight and 2-3% were obese. Obesity in childhood is associated with behavioural and social-emotional problems, an increase in metabolic abnormalities, orthopaedic complications, asthma and negative psychosocial health. At the start of our pilot study in 2004, the usual care of adolescent obesity in the Netherlands was referral to a dietician in the home care setting. A more intensive treatment programme aimed at attaining a healthy lifestyle was not available at that time. For this reason, the departments of paediatric endocrinology, nutrition and dietetics, medical psychology and public and occupational health of the VU University Medical Center Amsterdam the Netherlands, developed a multidisciplinary intervention program for obese adolescents, called Go4it. The effectiveness of the Go4it intervention was studied in a randomised controlled trial.
Go4it study
Obese adolescents (11-18 years) visiting the outpatient paediatric obesity clinic of the VU University Medical Center Amsterdam were randomly assigned to 1) intervention group (Go4it, n = 71) or 2) current regular care i.e. referral to a dietician in the home care setting (controls, n = 51). At baseline their mean weight was 93.6 kg, mean BMI was 33.5 kg/m2 and their mean BMI standard deviation score (BMIsds) was 2.9. Of the 122 adolescents, 12 adolescents were overweight and 110 adolescents were obese. Regarding ethnicity, 54 adolescents were of western descent and 68 adolescents were of non-western descent. Adolescents in the intervention group received a multidisciplinary group treatment focusing on: 1) increasing awareness of their current dietary, sedentary and physical activity behaviour (i.e. energy balance behaviour), 2) improving diet, 3) decreasing sedentary behaviour, 4) increasing levels of physical activity, and 5) coping with difficult situations (e.g. parties). Go4it consisted of 7 sessions with an interval of 2-3 weeks. After 6, 14, 26, and 36 weeks, booster group sessions were scheduled in order to encourage the adolescents to maintain or further improve their energy balance eating behaviour and physical activity behaviour and to discuss possible problems or questions. In addition, 2 separate sessions for the parents were organised. Outcome measures included body mass index standard deviation score (BMIsds), body composition, metabolic components and quality of life at 6 and
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