[Group therapy for the treatment of obesity in children and adolescents]. / Terapia de grupo para el tratamiento de la obesidad infantil.

THERAPY: Although obesity is one of the leading health problems in developed countries, effective treatment is lacking. The aim of the present study was to determine whether group therapy is more efficient in inducing weigh loss than individual therapy in the pediatric age group. EXPERIMENTAL DESIGN: Fifty obese patients, 15 preadolescents and 33 adolescents (12 boys and 23 girls) were studied. In all patients, dietary intake was modified to reduce calorie intake. Initially all patients were followed-up individually every 3 months (individual therapy) until the beginning of group therapy when the patients were seen monthly in groups of 10-15 patients with their parents (preadolescents) or alone (adolescents). In the group sessions, talks were given about diet and exercise. In each session, the patient who had shown the greatest improvement in habits and weight loss received a prize. The patients were followed-up for 2 years, with individual therapy in the first year and group therapy in the second. Differences in body mass index (BMI) z-score before the beginning of therapy and during therapy were analyzed using Student's paired T test. RESULTS: With individual therapy, no changes in BMI z-score were observed throughout the study. In contrast, with group therapy, BMI z-score decreased in all the groups studied. During the 1-year follow-up with individual therapy, 60 % of the patients gained more than 5 kg. With group therapy, only 10 % of patients gained more than 5 kg. CONCLUSIONS: In obese children and adolescents, group therapy was more efficient than individual therapy in inducing weight loss.

Terapia de grupo para el tratamiento de la obesidad infantil / Group therapy for the treatment of obesity in children and adolescents

Objetivos. No existen formas eficaces de tratamiento de la obesidad a pesar de constituir uno de los principales problemas sanitarios de los países desarrollados. En el presente trabajo estudiamos si la terapia de grupo es más eficaz para perder peso que la terapia individual en la edad pediátrica. Métodos. Se seleccionó un grupo de 50 pacientes obesos; 15 niños preadolescentes y 35 adolescentes (12 niños y 23 niñas). En todos ellos, tras la revisión de la dieta se introdujeron modificaciones para disminuir la ingesta calórica. Los niños fueron seguidos trimestralmente (terapia individual) hasta que se inició la terapia de grupo, realizándose a partir de entonces visitas mensuales en grupos de 10-15 niños, junto con sus padres (los preadolescentes) o solos (adolescentes). En las sesiones se comentaron temas nutricionales y formas de incrementar la actividad física. Además se dio un premio al niño que conseguía mejorar sus hábitos y perdía peso. Los pacientes fueron controlados durante 2 años, el primero con terapia individual y el segundo con terapia de grupo. Utilizando el test de la T-pareada se comparó la diferencia entre la z-score del índice de masa corporal (IMC) al inicio del tratamiento y durante el mismo. Resultados. Con la terapia individual no se observaron cambios en la z-score del IMC a lo largo del tiempo de seguimiento, mientras que con la terapia de grupo se observó una disminución significativa en todos los grupos. Durante el año de seguimiento con terapia individual un 60 % de los niños ganaron más de 5 kg, comparado con el 10 % observado durante la terapia de grupo. Conclusiones. En niños y adolescentes obesos, la terapia de grupo resultó más eficaz para perder peso que la terapia individual

Therapy. Although obesity is one of the leading health problems in developed countries, effective treatment is lacking. The aim of the present study was to determine whether group therapy is more efficient in inducing weigh loss than individual therapy in the pediatric age group. Experimental design. Fifty obese patients, 15 preadolescents and 33 adolescents (12 boys and 23 girls) were studied. In all patients, dietary intake was modified to reduce calorie intake. Initially all patients were followed-up individually every 3 months (individual therapy) until the beginning of group therapy when the patients were seen monthly in groups of 10-15 patients with their parents (preadolescents) or alone (adolescents). In the group sessions, talks were given about diet and exercise. In each session, the patient who had shown the greatest improvement in habits and weight loss received a prize. The patients were followed-up for 2 years, with individual therapy in the first year and group therapy in the second. Differences in body mass index (BMI) z-score before the beginning of therapy and during therapy were analyzed using Student's paired T test. Results. With individual therapy, no changes in BMI z-score were observed throughout the study. In contrast, with group therapy, BMI z-score decreased in all the groups studied. During the 1-year follow-up with individual therapy, 60 % of the patients gained more than 5 kg. With group therapy, only 10 % of patients gained more than 5 kg. Conclusions. In obese children and adolescents, group therapy was more efficient than individual therapy in inducing weight loss