Page 24 - Go4it

Chapter 2
Intervention
Go4it is a multidisciplinary group treatment for obese children that is based on the programmes of Braet et al. (11), Epstein et al. (13) and the materials of the Dutch Obesity Intervention in Teenagers (DOiT) (11,14). During 7 sessions with an interval of 2-3 weeks, the adolescents received education on dietary behaviour, physical activity and energy balance. They also received cognitive behavioural therapy in which they were learned how to improve their lifestyle regarding a healthy weight and how to maintain an adequate energy balance. Go4it was carried out multidisciplinary in an outpatient clinic with a dietician, paediatrician/endocrinologist and psychologist involved. The first session was focussed on increasing awareness of the current lifestyle. Besides dietary and activity journals, step counters (pedometers) were used to increase awareness of the actual behaviour. Next, the adolescents had to set goals with respect to improving their energy balance behaviour. Additionally cognitive-behavioural therapy characteristics were used, e.g. learning to cope with difficult situations (parties, holidays) and teasing. Go4it works with homework tasks, and the education is interactive. 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 behaviour and to discuss possible problems or questions. In addition, 2 separate sessions for the parents were organised. These parental sessions consisted of education concerning the health risks of overweight, healthy physical activity and dietary behaviour and how to support their children. Special materials were developed for this program; an information book, a workbook, and a dietary and activity diary. In addition, specific worksheets for every session were developed. The control group received the current regular care, consisting of referral to a dietician in the home care setting.
Study population
- Recruitment of the study population
All adolescents with overweight or obesity in the age range of 12-18 years who were referred to the outpatient paediatric obesity clinic of the VU University Medical Center were asked to participate. Overweight and obesity were defined according to the Cole criteria (15). A paediatrician interviewed all adolescents concerning past medical history, weight development, anthropometry, socio- economic status (SES) of the parents, and ethnicity. Additionally the following 3 questionnaires were administered as part of the regular care of the obesity clinic. The adolescents and their parents also received an information brochure about the study. Within 2 weeks, we phoned them to ask for their willingness to participate. Written informed consent was obtained from all adolescents as well as their parents.
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