Purpose of Study This study was designed to determine the effectiveness of a multidisciplinary approach to treating obesity in children and adolescents by interventions aimed at altering maladaptive dietary, exercise and sleep patterns. The team consists of a pediatrician, dietitian, behavioral psychologist, and sleep specialists. We present the preliminary results from this ongoing project, including baseline characteristics of the participants and factors associated with obesity in this population.
Methods Children and adolescents who are referred to the weight loss clinic by primary care providers undergo a baseline evaluation consisting of a history and physical examination. They answer standardized questionnaires about their diet, exercise, sleep habits, and quality of life. The subjects are counseled to make the appropriate lifestyle changes and are followed longitudinally to assess response.
Summary of Results A total of 19 female and 7 male subjects ages 4 to 16 years with BMI 21 to 50 have been enrolled so far and have been followed for up to 19 weeks (mean 6). Weight change over this time was −7.22 to + 3.48 kg (mean −0.4, SD 2.8). Obese individuals were more likely to be older (BMI vs age, Pearson's coefficient 0.605, p = .001) and were more likely to sleep less during the night (BMI vs sleep duration on weekdays, Pearson's coefficient −0.519, p = .007). Obese individuals were more likely to have a worse quality of life (BMI vs Pediatric Quality of Life Index, Pearson's coefficient 0.512, p .015). Sleep duration on weekday nights was 6 to 11 hours (mean 8.9, SD 1.1), and sleep deficits during weekdays were suggested by a 1- to 5-hour (mean 1.8, SD 2.1) difference between time spent sleeping in the night on weekends and weekdays. Sixty-one percent had a television in their rooms and watched 1 to 8 hours of television (mean 4.1, SD 2.2).
Conclusions Propensity for obesity increased with age in our subjects, likely due to an accumulation of genetic, behavioral, and environmental factors over time, suggesting the need for interventions to be instituted at an early age. Obese individuals in this group were more likely to sleep less in the night and were more likely to be sleep deprived. This is consistent with the results of other studies, which have shown obesity to be linked to short sleep times and the hormonal changes resulting from short sleep times, promoting obesity in these adults. Obese individuals are more likely to have a poorer quality of life. Multidisciplinary approach to managing obesity is likely to be effective, but further study on this subject is needed.
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