[Evaluation of the training program "OBELDICKS" for obese children and adolescents]. / Evaluation der Schulung "OBELDICKS" für adipöse Kinder und Jugendliche.

UNLABELLED: The evaluation of treatment programs in obese children and adolescents is uncommon but necessary to prove effectiveness and to improve treatment modalities. We studied the effectiveness of the a one-year structured outpatient training programme "OBELDICKS" consisting of physical exercise, nutrition education and behaviour therapy in 132 participants based on the criterions developed by the Institute of Medicine and German Obesity Group (degree of weight reduction, improvement of comorbidity and health behaviour, minimising of side effects). Furthermore, we analysed degree of overweight (SDS-BMI) two years after the end of the outpatient training (n = 60). - 74 % of participants reduced their overweight (intention to treat). The mean reduction of SDS-BMI was 0.43. 34 % of the participants was not obese any more at end of the training. The degree of overweight was significantly (p < 0.001) lower two years after intervention compared to baseline. The comorbidity was improved (significant reduction of the frequencies of hypertension, dyslipidaemia and hyperuricaemia). The nutrition, exercise and eating habits (cognitive control and disinhibition of control) were significantly improved. Side effects were not found. CONCLUSION: The effectiveness based on the criterions of the Institute of Medicine and the German Obesity Group was proven for the outpatient training "OBELDICKS". Long-term weight reduction can be achieved in most of the obese participating children due to this long-term, specialised treatment.

[Ambulant training programs for obese children. Criterions of comparison for the development of valid therapy recommendations]. / Ambulante Adipositasschulungen im Kindesalter - Vergleichskriterien zur Entwicklung validierter Behandlungsempfehlungen.

Valid knowledge concerning structure and contents of an ambulant training program for obese children and adolescents suggested by experts is still missing. In 1999/2000, we assessed a survey based on defined criterions in the "Arbeitsgemeinschaft für pädiatrische Diäthetik (APD)" and investigated the literature to cover and to compare based on defined criterions the spectrum of ambulant treatment models in Germany to advance guidelines for therapy in obese children. 13 ambulant training programs were detected. Training of children aged 8 to 12 years and their parents based on diet, behavioural treatment and sports therapy over couple of months without great experiences and without complete financing by health insurance were in common. Time volume of the training programs widely varies. In the seven evaluated training programs, up to one third of the patients broke off, while more than two third of the children successfully finished the training programs. The comparison of the programs failed on missing data concerning the collective, missing or different evaluation criteria, sometimes low number of patients and not standardised calculation of overweight. The survey reflects the often low experiences and the heterogeneous, insufficient evaluation of ambulant treatment models in Germany and demonstrates the great requirement of research. The schedule of criterions facilitates the comparison of programs to develop valid ambulant training programs for obese children.