Intervention studies in youth with obesity that can be translated into primary care
are limited. We compared a lifestyle intervention to a brief intervention applied
by primary care physicians (control group) for treating pediatric obesity in the primary
care setting. Seventy-six youth with obesity (body mass index [BMI] >95th percentile
or >90th percentile plus waist circumference >90th percentile, aged 9 to 17 years)
participated in a 12-month, randomized, controlled trial, conducted at a primary care
unit in Northern México from June 2006 through October 2007. Participants randomized
to lifestyle intervention attended a family-centered program consisting of 12 sessions
of behavioral curriculum, dietary advice from a registered dietitian (weekly for the
first 3 months and monthly thereafter), and monthly consultations with a primary care
physician. Control group participants attended monthly consultations with a primary
care physician who received a brief training on obesity. Forty-three (57%) participants
completed the 12 months of study. After 12 months, mean changes (95% confidence interval)
in body weight for the lifestyle group and the control group were -0.8 kg (-3.2, 1.5)
vs +5.6 kg (3, 8.2; P<0.001) and mean changes in BMI were -1.8 (-2.6, -0.9) vs +0.4
(-0.5, 1.3; P<0.001), respectively. Intention-to-treat analysis at 12 months confirmed
significant differences in primary outcomes (weight -3.5 kg, P=0.02; BMI -1.2, P=0.03)
in favor of the lifestyle group. This study provides preliminary evidence that primary
care physicians supported by a registered dietitian and a behavioral curriculum can
be a successful strategy for treating pediatric obesity in the primary care setting.
Copyright 2010 American Dietetic Association. Published by Elsevier Inc. All rights
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