Lifestyle intervention program benefits children with overweigh compared to children with obesity

Background: Lifestyle weight loss interventions represent the mainstay of treating children with obesity. Long-term follow-up studies of intervention programs are scarce. This study assessed the long-term effects and identified factors associated with significant weight loss. Methods: This prospective, observational study involved 165 children with body mass index (BMI) z-score ≥1.5 who participated in after-school intervention program. Main outcome measure: change in BMI z-scores; decreased BMI z-score ≥0.5 units was defined as clinically significant. Results: At baseline, 55/165 (33.3%) had BMI z-score 1.5–2 and 98 (59.4%) had BMI z-score >2. At follow-up (mean 5.4 ± 1.4 years), 80 (48.5%) had a clinically significant reduction in BMI z-score, while 56 (33.9%) reported a mildly decrease in BMI z-score of 0–0.5 and 29 (17.6%) reported increased BMI z-score. Lower BMI z-score at baseline and participation in sport activity at follow-up were associated with long-term decrease in BMI z-score. Participation in additional post-intervention weight control programs was correlated with weight gain. Conclusions: Intervention program was associated with long-term improvement in weight control, especially in children with mild obesity. Physical activity was related to long-term success. Participation in an additional intervention program was associated with failure of weight control.