News Release

Video-based program successful in treating children with obesity

Conference abstract, experimental study, people

Reports and Proceedings

European Society for Paediatric Endocrinology

KiCK programme exercise example

image: Example screenshot from the KiCK video-based programme for weight loss in children. view more 

Credit: Felix Reschke

Children and adolescents with obesity lost weight and showed improvements in metabolic health after following a 12-month, video-based weight loss programme, according to research presented today at the 60th Annual European Society for Paediatric Endocrinology Meeting. The multi-component, educational programme tackled food choices, meal quantities and physical activity during 12 months of the COVID-19 lockdown restrictions in Germany. Participants not only lost weight but also showed improvements in other measures of their metabolic health and dietary behaviour, all of which contribute to a better quality of life with a reduced risk of serious health issues in the future.

Obesity is a growing, global epidemic linked to many other long-term health problems including type 2 diabetes and heart disease, as well as creating an increased financial and care burden on health services. Amongst children and adolescents with obesity, there is an additional risk of psychological issues related to the stigma of being overweight. The incidence of being overweight and obesity in children is known to be multifactorial but in the majority of cases, holistic, family-centred educational programmes can have a beneficial effect on children’s health. These educational programmes normally provide long-term, outpatient care through attendance at regular sessions designed to guide changes in nutrition and physical activity as well as providing psychological counselling for children and their families. The restrictions imposed during the COVID-19 pandemic presented novel challenges for treating patients with obesity and necessitated a new approach.

In this study, Dr Felix Reschke and his colleagues in Germany investigated the effectiveness of a video-based weight loss programme in a group of 108 children and adolescents with obesity (aged 8-17 years) over 12 months. This comprehensive programme included educational seminars and workshops covering food choices, cooking and portion control, together with sessions on more challenging subjects such as emotional eating and the health consequences of obesity. The educational content was complimented by live cooking sessions, a weekly newsletter featuring tips and topical updates and even a live dance performance. Midway through the programme, parents competed against the children in a live quiz, assessing their knowledge of the topics covered, which was, reassuringly, won by the children. At the end of the study period, the majority of participants showed improvements in metabolic health including lower body mass index, decreased blood lipid levels and a reduction in factors related to insulin resistance. Participants were also making better food choices with reduced portions and less snacking.

Dr Reschke comments, “Successful treatment of childhood obesity is challenging work but we have demonstrated that adolescents with pre-existing obesity may be helped through video-based training. Participants showed improvements in their dietary choices, appetite control and portion sizes, which was reflected in better measures of their metabolic health and quality of life.”

Although Dr Reschke, cautions, “ These data are from a small group at a single centre, so it is imperative that these findings are repeated in larger groups and that we ensure these successes can be sustained, particularly outside pandemic restrictions.”

These findings confirm and extend a small study (doi.org/10.1515/jpem-2022-0104) that the team published following the first COVID-19 lockdown. They now plan to further investigate these positive results by testing the video-based training programme with parents of overweight kindergarten children, to evaluate whether it can help prevent the development of obesity, through earlier educational intervention.

Dr Reschke adds, “Our results are very hopeful that this approach may be a useful and cost-effective

model for treating obesity in children. It eliminates the need for regular face-to-face contact, which may be of particular use for those who have difficulty attending appointments. Although we must take care not to unnecessarily increase the amount of screen time used by children. It may be a fine line but our data suggest this approach is worthwhile.”

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Abstract P1-282

Significant improvement in dietary behaviors and quality of life among adolescents with obesity in the COVID19 lockdown through telehealth

Nora Struckmeyer1, Torben Biester1, Chantal Weiner1, Evelin Sadeghian1, Cathrin Guntermann1, Laura Galuschka1, Kisa Reck2, Jantje Weiskorn1, Kerstin Kapitzke1, Karin Lange3, Thomas Danne1, Felix Reschke1

1Children`s Hospitas AUF DER BULT, Hanover, Germany. 2Department of Sports Science, University of Hildesheim, Hildesheim, Germany. 3Medical Psychology, Hanover Medical School, Hanover, Germany

Background:

COVID19 Lockdown resulted in an extreme change in daily lifestyle with a significant increase in weight and loss of quality of life, as well as an increase in the risk of secondary health conditions even in young people. One reason for this is a fatal change in the nutritional situation, especially among adolescents. Convincing models to counter this problem are missing so far. Multiprofessional training programs could reveal an outstanding effect for secondary prevention of obesity in youth. Telehealth measures were successfully implemented several times during the COVID19 pandemic.

Methods:

Adolescents (8-17 years) with severe obesity referred through a large obesity consultation were interviewed using standardized dietary behavior questionnaires (FEV-K, FFL-K, FFV-K) and quality of life questionnaires (WHO-5, KIND-L) and enrolled in a structured multimodal education program for adolescents with overweight. The program content (sports, nutrition, medicine, psychology) was tought exclusively video-based. After the end of the program (12 months), the patients were interviewed again regarding eating behavior and quality of life. In addition, a clinical examination including analysis of blood parameters was performed before and after the program. The results were analyzed and compared with results from the pre-pandemic period (2017 - 2019).

Results:

108 children and adolescents (mean age 12.1 yrs; male 46.2%, BMI SDS 2.21) were studied and telemedicated. Based on a significantly increased intake of fatty and sugary foods and an increased amount of meals per day (7.2 meals per day), a significantly increased intake of vegetables and fruits as well as a massive decrease of sweets, snacks and soft drinks was observed after program participation, which corresponds to a significant improvement in dietary behavior also compared to the pre-pandemic period. The amount of meals per day decreased to 4.1 meals per day. The quality of life of the adolescents increased significantly. The BMI SDS and the blood parameters (cholesterol, triglycerides, HOMA index) showed a decreasing trend, which roughly corresponds to the effect of the pre-pandemic period.

Discussion & Conclusion:

This study demonstrated a beneficial effect on dietary behaviors and quality of life of adolescents with obesity during lockdown through video-based structured education. Future research needs to show the extent to which this effect is replicable with respect to new periods of contact restriction. It is possible that telemedicine obesity education components can reach a large number of patients and especially families in rural areas, and thus can be a supraregional support for adolescents with obesity.


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