Dao H H, Frelut M L, Oberlin F, Peres G, Bourgeois P, Navarro J
Physiology and Sports Medicine Department, Pitié-Salpêtrière University Hospital, Paris, France.
Int J Obes Relat Metab Disord. 2004 Feb;28(2):290-9. doi: 10.1038/sj.ijo.0802542.
To investigate if a multidisciplinary weight loss program in adolescents suffering severe obesity allows adequate growth and development and avoid lean mass loss.
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.
Total and segmental body composition was assessed by means of dual-energy X-ray absorptiometry.
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/m(2) and in girls from 38.4+/-4.1 to 28.4+/-4.1 kg/m(2). 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/m(2) 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.
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.
探讨针对重度肥胖青少年的多学科减重计划是否能使其实现充分的生长发育并避免去脂体重减少。
共有55名重度肥胖青少年（33名女孩和22名男孩）参加了一项为期6至12个月的跨学科减重计划。进行了渐进性次最大强度身体活动，并提供了针对身体活动能量水平较低的青少年的国家膳食津贴。
通过双能X线吸收法评估全身和各节段的身体成分。
平均身高显著增加（P<0.001）。男孩的平均体重指数（BMI）从34.5±3.2降至25.5±2.3kg/m²，女孩从38.4±4.1降至28.4±4.1kg/m²。身高按照预期模式增加（P<0.001）。去脂体重（LM）总量未发生变化，且在减重前后，男女的去脂体重均与青春期发育呈正相关。躯干的脂肪量（FM）下降最为显著（男孩为-63.2±10.1%，女孩为-51.5±11.4%）。男女的BMI和FM下降紧密相关。然而，斜率存在显著差异（P<0.0005），即BMI每降低1kg/m²，女孩的FM减少3.92kg，男孩减少5.44kg。在每种性别中，基线时的FM和治疗持续时间是FM减少的主要决定因素。
在青春期，尽管体重显著减轻，但仍可实现充分的生长发育并保持去脂体重。男孩和女孩的减重动力学明显不同。在青春期，无需低热量饮食即可显著减轻重度肥胖。
