Page 23 - Go4it

Background
Overweight and obesity in childhood are associated with negative psychosocial factors, orthopaedic complications, an increased risk for diseases such as hypertension, dyslipidaemia, asthma, sleep-apnoea and a strong increase of impaired glucose tolerance (1,2). Impaired glucose tolerance precedes the onset of type 2 diabetes mellitus (3). Overweight children are likely to remain overweight and are at increased risk of becoming obese compared to children of normal weight (4).
Sinha and co-workers found impaired glucose tolerance in 21% of obese children and 25% of obese adolescents (3). Four percent of these obese adolescents had type 2 diabetes mellitus. At the paediatric outpatient clinic of the VU University Medical Center, glucose-intolerance and insulin-resistance were diagnosed in 18% and 52% of obese adolescents, respectively (5). In 2003, the last Dutch national surveillance system of diabetes mellitus in children reported the first children with type 2 diabetes mellitus as a result of obesity.
Several reviews on interventions for treating obesity in children have been produced recently. These reviews suggest that there is some evidence that treatment of obesity in children and adolescents is feasible. However, there is a limited amount of data on effective components of programs to treat childhood obesity (6-10). Cognitive behavioural modification techniques have shown promising results regarding lifestyle changes in obese children (11). For obese adolescents, the impact of an intensive intervention programme aimed at attaining a healthy lifestyle has not yet been evaluated. The prevalence of obesity in the Netherlands is, analogous to the United States, expected to increase in the coming years (12). Therefore, there is an urgent need for interventions aimed at the prevention of obesity among adolescents as well as effective therapeutic interventions aimed at a healthy weight of the already obese.
For this reason, we developed Go4it, an intervention program for obese adolescents. This paper describes the design of the Go4it study; a randomised controlled trial (RCT) with an economic evaluation alongside. The aim of this study is to investigate the effectiveness and cost-effectiveness of this multidisciplinary group treatment for obese adolescents.
Methods
Design
The effectiveness of Go4it will be evaluated in a randomised controlled trial with an economic evaluation alongside. The Medical Ethics Committee of VU University Medical Center approved the study protocol.
Study design
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