Five-year follow-up of a cognitive-behavioural lifestyle multidisciplinary programme for childhood obesity outpatient treatment

Objective: Aim of this study is to examine the 5-year follow-up results of MI PIACE PIACERMI (I like to like and please myself), a cognitive-behavioural programme intended to obtain a weight growth regulation over an extended period. Design: Longitudinal observational clinical study. Setting: Hospital-based programme, through outpatient activities. Subjects: Thirty-one simple obese children, 13 boys and 18 girls, 6-12 years of age on admission. Intervention: The intervention was carried out by a multidisciplinary team (paediatrician, cognitive-behavioural psychologist, physical therapist). It employed cognitive-behavioural techniques, nutrition education, promotion of physical activity, setting a high value on free play in motion. The programme actively involves parents. The following measurements were taken on admission and at 5-year follow-up: height, weight, waist circumference, body mass index (BMI), BMI standardized (BMI-SDS), and adjusted BMI (a-BMI) as actual BMI/BMI (50th percentile)*100. Dietary habits were investigated by interview and 24-h recall. Parents completed the Family Habit Inventory and the Child Behaviour Checklist (CBCL). Motor skills were assessed by using Frostig's test. Results: The dropout rate was 35.5 %. In subjects who completed the 5-year follow-up, the mean and s.d. of BMI-SDS and a-BMI were, respectively, 4.23±0.71 and 54.7%±9.0 at baseline and 2.74±0.85 and 43.2%±17.3 at the last visit. Waist circumference decreased. Family habits improved significantly. Total energy intake was significantly reduced. Emotional and social aspects of obesity-related behaviours showed positive changes. Motor skills globally improved. Conclusions: The study provides further evidence that positive persistent results may be obtained in obese children with treatment programmes combining a lifestyle centred approach, parental involvement, nutrition education and cognitive-behavioural strategies.