Adam S, Westenhöfer J, Rudolphi B, Kraaibeek H K
Hochschule für Angewandte Wissenschaften, Hamburg.
MMW Fortschr Med. 2008 Apr 10;150 Suppl 1:7-15.
In 2003, the program "The combined DAK therapy of obesity for children and adolescents", funded and conducted by the Deutsche Angestellten Krankenkasse (DAK) (A German Health Insurance Company), has started. The whole treatment lasts for 1 year including an initial inpatient therapy for 6 weeks followed by an outpatient treatment at home that adresses the overweight patients and their families. The therapy contents are developed according to the recommendations of the "Arbeitsgemeinschaft Adipositas im Kindes- und Jugendalter (AGA)". In a prospective cohort study a sample of 604 subjects was studied in order to examine the achievement of the treatment goals weight reduction, behaviour modification and improvement of quality of life. The development of weight was evaluated using BMI-SDS. 44,1% of children and adolescents had a successful weight reduction, they reduced their weight at least by 0,3 BMI-SDS. Furthermore, significant changes of health behaviour, physical fitness and quality of life were observed. However, during the outpatient treatment an impairment of some behaviour changes were observed. Nevertheless, the study has identified significant, positive effects in weight loss, behaviour modifications, changes in physical fitness and in the development of quality of life as a result of the therapy. It is demonstrated that a relapse in "old behaviour" followed by an increase of weight after the inpatient treatment can be avoided bythe subsequent outpatient therapy.
2003年，由德国职员健康保险基金（DAK）（一家德国健康保险公司）资助并开展的“儿童及青少年肥胖联合DAK治疗”项目启动。整个治疗为期1年，包括为期6周的初始住院治疗，随后是针对超重患者及其家庭的居家门诊治疗。治疗内容是根据“儿童及青少年肥胖问题协作组（AGA）”的建议制定的。在一项前瞻性队列研究中，对604名受试者进行了抽样研究，以检验减肥、行为改变和生活质量改善等治疗目标的达成情况。使用BMI-SDS评估体重变化。44.1%的儿童和青少年成功减重，他们的体重至少降低了0.3个BMI-SDS。此外，还观察到健康行为、身体素质和生活质量有显著变化。然而，在门诊治疗期间，观察到一些行为改变受到了损害。尽管如此，该研究确定了该疗法在减肥、行为改变、身体素质变化和生活质量改善方面有显著的积极效果。结果表明，后续的门诊治疗可以避免住院治疗后出现“旧行为”复发并导致体重增加的情况。
