Obesity in childhood and adolescence. Evaluation of a therapeutic model based on a frequent clinical intervention
Lilia Santiago1, Arturo Perea Martínez1, Gloria Elena López Navarrete1, Miriam Padrón Martínez1, Ana Lidia González Valadez1, Verónica García Osorio1, Aranza Lilián Perea Caballero1, Paul Ríos1, Ariadna Guadalupe Lara Campos1, María De los Ángeles Hernández López1, Diana Circe Solís Aguilar1, Corina De la Paz Morales1, Brenda Denise Narváez Lima1
1National Institute of Paediatrics, México, Mexico
Objectives and Study:
To evaluate the impact of an intervention model based on the promotion and reinforcement of healthy habits for the treatment of obesity and its complications in children and adolescents. Exploratory, descriptive, prospective and longitudinal study.
The study population consists of a total of 27 individuals between 5 and 18 years old who attended for the first time to the Obesity and Adolescents Clinic of the National Institute of Paediatrics (COAINP) with a diagnosis of overweight (Z score of Body Mass Index [BMI] above +1 Standard Deviation [SD] and up to +1.99 DE for age/sex) and obesity (BMI Z score above +2 SD for age/sex) according to international standards without presenting any intercurrent pathology. The intervention design consists on a basal consultation in which they were evaluated by a multidisciplinary health team. Subsequently, a weekly consultation was granted up to a total of 8 reviews, followed by a monthly consultation up to 6 times to complete 8 months of total intervention. The clinical indicators evaluated and registered in each consultation were: total body weight, waist circumference, eating patterns, medical-nutritional treatment follow-up and psychosocial evaluation.
The average result of the study revealed a decrease of 2.23 kg of total body weight, 3.68 cm of waist circumference and an important adherence to the recommendations of healthy habits in the first 8 weeks with respect to the baseline values. The final result after 8 months of intervention revealed an average decrease of 931g of total body weight, the value of the waist circumference was maintained at 3.67cm less than the baseline and good maintenance was shown in the attachment to healthy habits.
Successful treatments for obesity are limited. Intervention models based on constant and frequent surveillance seem to facilitate adherence to recommendations, obtain results of lifestyle improvement and perpetuate the result for periods longer than half a year. In the present study, the work on the ability to acquire healthy habits, shows a clear relationship between positive results with the weekly frequency of intervention, while the spacing of consultations slows down the beneficial result. It is important to distinguish that the model used in this study, in addition to achieving good results, is easy to replicate, adapt and develop viability at all levels of care in Mexico.