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Effects of a multidisciplinary weight loss intervention on body composition in obese adolescents

International Journal of Obesity volume 28, pages 290–299 (2004)Cite this article

Abstract

OBJECTIVE: To investigate if a multidisciplinary weight loss program in adolescents suffering severe obesity allows adequate growth and development and avoid lean mass loss.

DESIGN: A total of 55 adolescents (33 girls and 22 boys) suffering severe obesity were enrolled in an interdisciplinary weight reduction program lasting 6–12 months. Progressive submaximal physical activity was performed and national dietary allowances for adolescents with low levels of physical activity energy were provided.

MEASUREMENTS: Total and segmental body composition was assessed by means of dual-energy X-ray absorptiometry.

RESULTS: The mean height significantly increased (P<0.001). The mean body mass index (BMI) dropped in boys from 34.5±3.2 to 25.5±2.3 kg/m2 and in girls from 38.4±4.1 to 28.4±4.1 kg/m2. Height increased according to the expected pattern (P<0.001). Total lean mass (LM) did not vary and was positively correlated to pubertal development in both sexes before and after weight loss. Steepest drop in fat mass (FM) was observed in the trunk (−63.2±10.1% in boys and –51.5±11.4% in girls). Decrease in BMI and FM was tightly correlated in both sexes. However, slopes significantly differed (P<0.0005) so that a decrease of 1 kg/m2 in BMI corresponded to a decrease of 3.92 kg in FM in girls and of 5.44 kg in boys. In each sex, FM at baseline and duration of the treatment were the main determinants of the decrease in FM.

CONCLUSION: During adolescence, despite a major weight loss, adequate growth and preservation of LM can be achieved. Weight loss kinetics markedly differs between boys and girls. Low-calorie diets are unnecessary to achieve a marked reduction of severe obesity during puberty.

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References

  1. Rolland-Cachera MF, Castebon K, Arnault N, Bellisle F, Romano MC, Lehingue Y, Frelut ML, Hercberg S . Body mass index in 7 to 9-y old French children: frequency of obesity, overweight and thinness. Int J Obes Relat Metab Disord 2002; 26: 1610–1616.

    Article  PubMed  Google Scholar 

  2. Bar-Or O, Foreyt J, Bouchard C, Brownell KD, Dietz WH, Ravussin E, Sable AD, Schwenger S, Jeor SC, Torun B . Physical activity, genetic, and nutritional considerations in childhood weight management. Med Sci Sports Exerc 1998; 30: 2–10.

    Article  CAS  PubMed  Google Scholar 

  3. Dietz WH . Health consequences of obesity in youth: childhood predictors of adult disease. Pediatrics 1998; 101: 518–525.

    CAS  PubMed  Google Scholar 

  4. Must A, Jacques PF, Dallai GE, Bajema CJ, Dietz WH . Long-term morbidity and mortality of overweight adolescents: a follow-up of the Havard Growth Study of 1922 to 1935. N Engl J Med 1992; 327: 1350–1355.

    Article  CAS  PubMed  Google Scholar 

  5. Ailhaud G, Bougnères PF, Charles HA, Frelut ML, Martinouski M, Poulain IR, Ricquier D, Rivière D, Vaysse C, Ziegler O, Etiemble J, Prévention de l'obésité chez l'enfant In: INSERM (eds). Obésité: Dépistage et Prévention chez l'Enfant. Inserm: Paris; 2000. pp 51–57.

    Google Scholar 

  6. Epstein LH, Goldfield GS . Physical activity in the treatment of childhood overweight and obesity: current evidence and research issues. Med Sci Sports Exerc 1999; 31: S553–S559.

    Article  CAS  PubMed  Google Scholar 

  7. Frelut ML . Interdisciplinary residential treatment. In: Burniat W, Cole T, Lissau I, Poskitt E (eds). Child and adolescent obesity. Cambridge University Press; 2002. pp 377–388.

    Chapter  Google Scholar 

  8. Gately PJ, Coocke CB, Butterly RJ, Mackreth P, Carroll S . The effects of a children's summer camp programme on weight loss with a 10 month follow up. Int J Obes Relat Metab Disord 2000; 24: 1445–1452.

    Article  CAS  PubMed  Google Scholar 

  9. Epstein LH, Valoski A, McCurley J . Effect of weight loss by obese children on long-term growth. Am J Dis Child 1993; 147: 1076–1080.

    CAS  PubMed  Google Scholar 

  10. Svendsen OL, Haarbo J, Hassager C, Christiansen C . Accuracy of measurements of body composition by dual energy X ray absorptiometry in vivo. Am J Clin Nutr 1993; 57: 605–608.

    Article  CAS  PubMed  Google Scholar 

  11. Mazess RB, Barden HS, Bisek JP, Hanson J . Dual energy X-ray absorptiometry for total body and regional bone mineral and soft tissue composition. Am J Clin Nutr 1990; 51: 1106–1112.

    Article  CAS  PubMed  Google Scholar 

  12. Goran MI, Driscoll P, Johnson R, Nagy TR, Hunter G . Cross calibration of body composition techniques against dual energy X ray absorptiometry in young children. Am J Clin Nutr 1996; 63: 299–305.

    Article  CAS  PubMed  Google Scholar 

  13. Figueroa-Colon R, Mayo MS, Treuth MS, Aldridge RA, Weinsier RL . Reproducibility of dual energy X-ray absorptiometry measurements in pre-pubertal girls. Obes Res 1998; 6: 262–267.

    Article  CAS  PubMed  Google Scholar 

  14. Wong WW, Hergenroeder AC, Stuff JE, Butte NF, O'Brian Smith E, Ellis KJ . Evaluating body fat in girls and female adolescents: advantages and disadvantages of dual energy X ray absorptiometry. Am J Clin Nutr 2002; 76: 384–389.

    Article  CAS  PubMed  Google Scholar 

  15. Frelut ML . Méthodes de diagnostic de l'obésité chez l'enfant. In: INSERM (eds). Obésité: Dépistage et Prévention chez l'Enfant. Inserm: Paris; 2000. pp 99–116.

    Google Scholar 

  16. Rolland-Cachera MF, Cole TJ, Sempe M, Tichet J, Rossignol C, Charraud A . Body mass index variations: percentile from birth to 87 years. Eur J Clin Nutr 1991; 45: 13–21.

    CAS  PubMed  Google Scholar 

  17. Tanner JM, Whitehouse RH . Clinical longitudinal standards for height, weight, height velocity and weight velocity and stages of puberty. Arch Dis Child 1976; 51: 170–179.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  18. Apports Nutritionnels Conseillés pour la Population Française. In: A Martin (eds). Lavoisier, Paris; 2002. 60 pp.

  19. HOLOGIC QDR-1000/W™. Operator's manual and user's guide. Hologic Inc.: Waltham, MA; 1990.

  20. Eliakim A, Kaven G, Berger I, Friedland O, Wolach B, Nemet D . The effect of a combined intervention on body mass index and fitness in obese children and adolescents-a clinical experience. Eur J Ped 2002; 161: 449–454.

    Article  Google Scholar 

  21. Togashi K, Matsuda H, Rankinen T, Tanaka S, Bouchard C, Kamiya H . A 12-year follow-up study of treated obese children in Japan. Int J Obes Relat Metab Disord 2002; 26: 770–777.

    Article  CAS  PubMed  Google Scholar 

  22. Sothern MS, Udall JN, Suskind RM, Vargas A, Blecker U . Weight loss and growth velocity in obese children after very low calorie diet, exercise and behavior modification. Acta Paediatr 2000; 89: 1036–1043.

    Article  CAS  PubMed  Google Scholar 

  23. Figueroa-Colon R, Mayo MS, Aldridge RA, Winder T, Weinsier RL . Body composition changes in Caucasian and African American children and adolescents with obesity using dual energy X-ray absorptiometry measurements after a 10 week weight loss program. Obes Res 1998; 6: 326–331.

    Article  CAS  PubMed  Google Scholar 

  24. Bar-Or O, Baranowski T . Physical activity, adiposity and obesity among adolescents. Ped Exer Sci 1994; 6: 348–360.

    Article  Google Scholar 

  25. Epstein LH, Wing RR, Penner BC, Kress MJ . Effect of diet and controlled exercise on weight loss in obese children. J Pediatr 1985; 107: 358–361.

    Article  CAS  PubMed  Google Scholar 

  26. Nuutinen O, Knip M . Long-term weight control in obese children: persistence of treatment outcome and metabolic changes. Int J Obes Relat Metab Disord 1992; 16: 279–287.

    CAS  PubMed  Google Scholar 

  27. Epstein LH, Myers MD, Raynor HA, Saelens BE . Treatment of pediatric obesity. Pediatrics 1998; 101: 554–570.

    CAS  PubMed  Google Scholar 

  28. Frelut ML, Flodmark CE . The obese adolescent. In: Burniat W, Cole T, Lissau I, Poskitt E (eds). Child and adolescent obesity. Cambridge University Press: Cambridge; 2002. pp 154–170.

    Chapter  Google Scholar 

  29. Reybrouk TJ, Vinckx J, Van den Berghe G, Vanderschueren-Lodeweyckx M . Exercise therapy and hypocaloric diet in the treatment of obese children and adolescents. Acta Paediatr Scand 1990; 79: 84–89.

    Article  Google Scholar 

  30. Valverde MA, Patin RV, Oliveira FLC, Lopez FA, Vitolo MR . Outcomes of obese children and adolescents enrolled in a multidisciplinary health program. Int J Obes Relat Metab Disord 1998; 22: 513–519.

    Article  CAS  PubMed  Google Scholar 

  31. Bitar A, Vernet J, Coudert J, Vermorel M . Longitudinal changes in body composition, physical capacities and energy expenditure in boys and girls during the onset of puberty. Eur J Clin Nutr 2000; 39: 157–163.

    Article  CAS  Google Scholar 

  32. Vermorel M, Vernet J, Bitar A, Fellmann N, Coudert J . Daily energy expenditure, activity patterns, and energy costs of the various activities in French 12–16-y-old adolescents in free living conditions. Eur J Clin Nutr 2002; 56: 819–829.

    Article  CAS  PubMed  Google Scholar 

  33. Boot AM, Bouquet J, de Ridder MAJ, Krenning EP, de Muinck Keizer-Schrama SMPF . Determinants of body composition measured by dual X-ray absorptiometry in Dutch children and adolescents. Am J Clin Nutr 1997; 66: 232–238.

    Article  CAS  PubMed  Google Scholar 

  34. Nelson DA, Barondess DA . Whole body bone, fat and lean mass in children: comparison of three ethnic groups. Am J Phys Anthropol 1997; 103: 157–162.

    Article  CAS  PubMed  Google Scholar 

  35. Barbeau P, Gutin B, Litaker, Owens S, Riggs S, Okuyama T . Correlates of individual differences in body composition changes resulting from physical training in obese children. Am J Clin Nutr 1999; 69: 705–711.

    Article  CAS  PubMed  Google Scholar 

  36. Saris WH . Very low calorie diets and sustained weight loss. Obes Res 2001; 9 (Suppl 4): 295S–301S.

    Article  PubMed  Google Scholar 

  37. Goran MI, Gower BA . Relation between visceral fat and disease risk in children and adolescents. Am J Clin Nutr 1999; 70 (Suppl): 149S–156S.

    Article  CAS  PubMed  Google Scholar 

  38. Daniels SR, Morrison JA, Sprecher DL, Khoury P, Kimball TR . Association of body fat distribution and cardiovascular risk factors in children and adolescents. Circulation 1999; 99: 541–545.

    Article  CAS  PubMed  Google Scholar 

  39. Freedman DS, Serdula MK, Srinivasan SR, Berenson GS . Relation of circumferences and skinfold thickness to lipid and insulin concentrations in children and adolescents: the Bogalusa Heart Study. Am J Clin Nutr 1999; 69: 308–317.

    Article  CAS  PubMed  Google Scholar 

  40. Tounian P, Aggoun Y, Dubern B, Varille V, Guy Grand B, Sidi D, Girardet JP, Bonnet D . Presence of increased stiffness of the common carotid artery and endothelial dysfunction in severely obese children: a prospective study. Lancet 2001; 358: 1400–1404.

    Article  CAS  PubMed  Google Scholar 

  41. Caprio S, Hyman LD, McCarthy S, Lange R, Bronson M, Tamborlane WV . Fat distribution and cardiovascular risk factors in obese adolescent girls: importance of the intra abdominal fat depot. Am J Clin Nutr 1996; 64: 12–17.

    Article  CAS  PubMed  Google Scholar 

  42. Maffeis C, Pietrobelli A, Grezzani A, Provera S, Tato L . Waist circumference and cardiovascular risk factors in pre-pubertal children. Obes Res 2001; 9: 179–187.

    Article  CAS  PubMed  Google Scholar 

  43. Goran MI, Gower BA, Treuth M, Nagy TR . Prediction of intra-abdominal and subcutaneous abdominal adipose tissue in healthy pre-pubertal children. Int J Obes Relat Metab Disord 1998; 22: 549–558.

    Article  CAS  PubMed  Google Scholar 

  44. Taylor RW, Jones IE, Williams SM, Goulding A . Evaluation of waist circumference, waist to hip ratio, and the conicity index as screening tool for high trunk fat mass, as measured by dual energy X ray absorptiometry, in children aged 3–19 y. Am J Clin Nutr 2000; 72: 490–495.

    Article  CAS  PubMed  Google Scholar 

  45. Ogle GD, Allen JR, Humphries IR, Lu PW, Briody JN, Morley K, Howman-Giles R, Cowell CT . Body composition assessment by dual energy X-ray absorptiometry in subjects aged 4–26 y. Am J Clin Nutr 1995; 61: 746–753.

    Article  CAS  PubMed  Google Scholar 

  46. Treuth MS, Hunter GR, Figueroa-Colon R, Goran MI . Effects of strength training on intra-abdominal adipose tissue in obese pre-pubertal girls. Med Sci Sports Exerc 1998; 30: 1738–1743.

    Article  CAS  PubMed  Google Scholar 

  47. Gutin B, Cucuzzo N, Islam S, Smith C, Moffatt R, Pargman D . Physical training improves body composition of black obese 7 to 11 year old girls. Obes Res 1995; 3: 305–312.

    Article  CAS  PubMed  Google Scholar 

  48. Pietrobelli A, Faith MS, Allison DB, Gallagher D, Chiumello G, Heymsfied SB . Body mass index as a measure of adiposity among children and adolescents: a validation study. J Pediatr 1998; 132: 204–210.

    Article  CAS  PubMed  Google Scholar 

  49. Lindsay RS, Hanson RL, Roumain J, Ravussin E, Knowler C, Tataranni PA . Body mass index as a measure of adiposity in children and adolescents: relationship to adiposity by dual energy X ray absorptiometry and to cardiovascular risk factors. J Clin Endocrinol Metab 2001; 86: 4061–4067.

    Article  CAS  PubMed  Google Scholar 

  50. Hannan WJ, Wrate RM, Cowen SJ, Freeman CP . Body mass index as an estimate of body fat. Int J Eat Disord 1995; 18: 91–97.

    Article  CAS  PubMed  Google Scholar 

  51. Goulding A, Gold E, Cannan R, Taylor RW, Williams S, Lewis-Barned NJ . DEXA supports the use of BMI as a measure of fatness in young girls. Int J Obes Relat Metab Disord 1996; 20: 1014–1021.

    CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Physiology and Sports Medicine Department, Pitié-Salpêtrière University Hospital, Paris, France

    H H Dao & G Peres

  2. Rheumatology Department, Pitié-Salpêtrière University Hospital, Paris, France

    H H Dao, F Oberlin & P Bourgeois

  3. Gastro-enterology Department, Robert-Debré University Hospital, AP-Hop Paris, Pediatric Therapeutic Center, Margency, France

    M L Frelut & J Navarro

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  1. H H Dao
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Correspondence to G Peres.

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Dao, H., Frelut, M., Oberlin, F. et al. Effects of a multidisciplinary weight loss intervention on body composition in obese adolescents. Int J Obes 28, 290–299 (2004). https://doi.org/10.1038/sj.ijo.0802542

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