Page 17 - Go4it

Energy requirements and body composition
A prolonged imbalance between energy intake (diet) and energy expenditure (physical activity, sedentary behaviour) is the primary cause of the overweight problem. To get more insight into the energy needs of obese adolescents resting energy expenditure (REE) is assessed by indirect calorimetry (31). Next to REE, accurate estimation of fat-free mass (FFM) and fat mass (FM) is necessary to understand the effect of obesity on body composition but also for establishing reachable goals for weight-loss programs. Chapter 6 and 7 of this thesis focus on the accuracy of estimating REE and FFM in overweight and obese adolescents.
Aim and outline of this thesis
The main objective of this thesis is to describe the effectiveness of the multidisciplinary group treatment ‘Go4it’ in obese adolescents.
Chapter 2 describes the design of the randomised controlled trial evaluating Go4it. Chapter 3 describes the prevalence of behavioural problems and social- emotional functioning in adolescents referred to the VU University Medical Center outpatient obesity clinic. Chapter 4 describes the long-term effects of the Go4it multidisciplinary group treatment for obese adolescents on anthropometry, body composition, and metabolic indicators. In chapter 5 the long-term effect of the Go4it multidisciplinary group treatment on Health Related quality of life is presented. Chapter 6 compares resting energy expenditure predictive equations with measured values by indirect calorimetry. Chapter 7 describes the comparison and validation of the fat-free mass predictive equation by bioelectrical impedance analysis with dual-energy x-ray absorptiometry measurements. The final chapter – chapter 8 – summarizes the main findings of this thesis and critically discusses theoretical, practical, and methodological issues derived from this thesis.
General introduction
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