Ein strukturiertes Behandlungs- und Schulungsprogramm bei Adipositas

Zusammenfassung

Übergewicht und Adipositas bei Kindern und Jugendlichen nehmen zu. Therapie und Prävention sind gesundheitspolitische Herausforderungen. Ziel der Untersuchung war die Entwicklung und Evaluation eines strukturierten Behandlungs- und Schulungsprogrammes (SBSP, inklusive Elternschulung).

Patienten: Alle Kinder und Jugendlichen (n = 57, Alter 14,2 ± 2,4 Jahre) wurden in die Untersuchung eingeschlossen, die 04–12/2004 am SBSP teilgenommen hatten.

Ergebnisse: Während des SBSP (34,1 ± 6,9 Tage) sank der BMI/BMI-SDS von 30,3 ± 4,4 kg/m²/2,38±0,57 auf 27,7 ± 4,0 kg/m²/2,00±0,61 (p <0,001/p <0,001) und nach 6 Monaten weiter auf 26,7 ± 3,8 kg/m²/1,85 ± 0,61 (p = 0,050/ p = 0,046). Initiale und weitere Gewichtsabnahme korrelierten mit der Dauer des stationären Aufenthaltes (r = 0,41, p = 0,030). Die multivariate Analyse (R-Square = 0,13) ergab eine Assoziation zw. der Dauer des Aufenthaltes und der Gewichtsabnahme (ß = 0,41, p = 0,030). Nach 6 Monaten hatten die Patienten 3,4 ± 1,0 Mahlzeiten/d und körperliche Aktivität an 2,7 ± 1,7 Tagen/Wo. (51,8 ± 40,8 Minuten/d). Von 16 der 57 Patienten (28%) hatten Eltern am SBSP (Elternkurs) teilgenommen. Kinder, deren Eltern am SBSP teilgenommen hatten, waren tendenziell zufriedener.

Diskussion: Das SBSP ist gut geeignet zur Gewichtsreduktion und Stabilisierung des BMI.

Summary

There is a drastic increase in overweight and obesity among children and adolescents. Therapy and prevention are two of the most important challenges. The aim of the trial was the development and evaluation of a structured treatment and teaching programme (STTP, inclusive a teaching programme for patients’ parents).

Patients: All children and adolescents (n = 57, age 14.2 ± 2.4 years) were studied participated in the STTP during the period 04–12/2004.

Results: During participation in the STTP (34.1 ± 6.9 days) the BMI/BMI-SDS decreased from 30.3 ± 4.4 kg/m²/2.38 ± 0.57 to 27.7 ± 4.0 kg/m²/2.00 ± 0.61 (p <0.001/p <0.001) and to 26.7 ± 3.8 kg/m²/1,85 ± 0,61 (p = 0.050/p = 0.046) after 6 months. The initial and weight reduction during the follow-up period correlated with the duration of hospitalization (r = 0.41, p = 0.030). In multivariate analysis (R-square = 0.13) there was an association between duration of hospitalization and weight reduction (ß = 0.41, p = 0.030). At the follow-up examination patients had 3.4 ± 1.0 meals/d and physical activity at 2.7 ± 1.7 days/week (51.8 ± 40.8 minutes/d). The parents of 16/57 patients (28%) took part in the specially STTP too. Children of parents, participated in the special STTP were more convenient.

Discussion:The STTP is highly effective and leads to stabilisation of BMI.

Schlüsselwörter

Body mass index - Ernährungstherapie - Sporttherapie - Diabetes mellitus - arterielle Hypertonie

Keywords

Body mass index - diet - physical activity - diabetes mellitus - arterial hypertension

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