Cooper Christopher, Sarvey Sharon, Collier David, Willson Charles, Green Ira, Pories Mary Lisa, Rose Mary Ann, Escott-Stump Sylvia, Pories Walter
East Carolina University Brody School of Medicine, Greenville, North Carolina 27834, USA.
Surg Obes Relat Dis. 2006 Nov-Dec;2(6):622-6. doi: 10.1016/j.soard.2006.07.010. Epub 2006 Oct 3.
The alarming rise in childhood obesity has resulted in a number of bariatric surgical initiatives. To interpret the outcomes, a comparison with a nonoperative approach is prudent.
In 2003, 2004, and 2005, we measured the outcomes produced by an isolated summer camp in North Carolina for 74, 99, and 89 obese children and adolescents with a mean age of 12.7 +/- 2.3, 13.0 +/- 1.9, and 13.2 +/- 1.8 years and initial body mass index (BMI) of 33.1 +/- 5.7, 33.4 +/- 6.4, and 32.9 +/- 7.0 kg/m2, respectively. The camp featured a 1700/d caloric diet, daily aerobic and resistance weight training exercise, nutrition classes, and weekly sessions with a psychologist. The changes in weight, BMI, body shape measurements, and fitness level were assessed. The average length of stay was 4.3, 4.2, and 4.4 weeks, respectively, in 2003, 2004, and 2005.
The BMI, body shape, and weight change measures significantly improved during each of the summers. The campers lost 1.6, 2.0, and 1.8 kg/wk during each of the 3 years. Their waist measurements decreased by 9.1 +/- 5.12 cm, 9.9 +/- 5.6 cm, and 8.1 +/- 5.8 cm. Significant improvements occurred in the timed sprints, .5-mile (0.8-km) run, and vertical jump. Of those campers staying for two summers, 4.4% continued to reduce their BMI despite growth, 56.5% maintained their BMI at less than the initial baseline measurement, and 39.1% increased their BMI to greater than the baseline. The co-morbidities also improved. One camper, aged 15 years, weighing 211 kg, progressed from being able to walk 3 steps to managing the 100-yard (91-m) dash in 42 seconds after losing 35 kg in 8 weeks.
Diets, exercise, and behavioral modification are useful approaches in severely obese children that can, in some, produce significant albeit expensive long-term results. Recidivism is a problem. Surgical outcomes must compare favorably with these outcomes.
儿童肥胖率的惊人上升引发了多项减肥手术倡议。为了解手术效果，与非手术方法进行比较是明智之举。
在2003年、2004年和2005年，我们对北卡罗来纳州一个独立夏令营中74名、99名和89名肥胖儿童及青少年的效果进行了测量，这些儿童及青少年的平均年龄分别为12.7±2.3岁、13.0±1.9岁和13.2±1.8岁，初始体重指数（BMI）分别为33.1±5.7、33.4±6.4和32.9±7.0kg/m²。该夏令营提供每日1700卡路里的饮食、日常有氧和抗阻重量训练、营养课程以及每周一次的心理咨询。评估了体重、BMI、身体形态测量值和体能水平的变化。2003年、2004年和2005年的平均停留时间分别为4.3周、4.2周和4.4周。
在每个夏天，BMI、身体形态和体重变化指标均有显著改善。在这三年中，营员们每周分别减重1.6kg、2.0kg和1.8kg。他们的腰围分别减少了9.1±5.12cm、9.9±5.6cm和8.1±5.8cm。在定时短跑、0.5英里（0.8公里）跑和垂直跳方面有显著改善。在参加了两个夏天夏令营的营员中，4.4%的人尽管身体成长但BMI仍持续下降，56.5%的人BMI维持在低于初始基线测量值的水平，39.1%的人BMI升至高于基线水平。合并症也有所改善。一名15岁、体重211kg的营员，在8周内减重35kg后，从只能走3步发展到能够在42秒内跑完100码（91米）短跑。
饮食、运动和行为改变对于重度肥胖儿童是有用的方法，在一些情况下可以产生显著但昂贵的长期效果。复发是一个问题。手术效果必须优于这些结果。
