[Follow-up study of severely overweight adolescents 4 years following inpatient weight loss with a low calorie protein-carbohydrate diet].

Very low calorie protein/carbohydrate diets have proved to be efficient and safe in the treatment of obesity in childhood and early adolescence. The follow-up study at issue shows that subsequent to short-term therapy no further reduction in weight is to be expected without adequate care following the diet. Between 1980 and 1983, 27 adolescent patients were treated for severe obesity (78.12% +/- 18.3% overweight, mean +/- s.e.m.) at the metabolic ward of the department of pediatrics, University of Vienna. The administration of a very low calorie protein/carbohydrate diet (VLCD) for 26 (+/- 7) days led to a considerable reduction in overweight (8.1 +/- 2.9 kg). On dismission the percentual overweight had decreased to 59.4 (+/- 24)%. After 4.4 (+/- 0.7) years the weight of 11 of the 27 patients could be controlled, 10 patients refused further cooperation and the remaining 6 could not be addressed. The body mass index (weight/height) had risen from 29.4 (+/- 1.2) to 43.0 (+/- 6.0) with 10 of 11 patients, corresponding to a percentual overweight of 88.2 (+/- 18.1)% at the follow-up date. Only one girl had reduced overweight by 45%, the BMI had fallen from 33.9 to 27.1. Furthermore, our data suggest that obesity induces a significant increase in blood pressure in adolescents. This rise is apparently independent of the age related increase in blood pressure and revertible by weight loss. The results we have to hand show that long-term weight reduction has only been achieved in 1 of 11 cases, with none of the adolescents having participated regularly in an outpatient after-care program.(ABSTRACT TRUNCATED AT 250 WORDS)