Buchholz Annick, Howard Andrea L, Baldwin Katherine, Hammond Nicole G, Mohipp Charmaine, Rutherford Jane, Kazoun Fatima, Clark Laurie, Adamo Kristi, Goldfield Gary, Hadjiyannakis Stasia
Centre for Healthy Active Living, Children's Hospital of Eastern Ontario, Ottawa, Ontario.
Department of Psychology, Carleton University, Ottawa, Ontario.
Paediatr Child Health. 2019 Jul 12;25(7):439-446. doi: 10.1093/pch/pxz088. eCollection 2020 Nov.
The objective of the present study is to examine physical and mental health trajectories of change in youth with severe obesity attending a tertiary care weight management program. It was predicted that younger children would show favourable changes in body mass index (BMI), markers of cardiovascular health, quality of life, and mental health.
This 2-year longitudinal study examined health trajectories of children referred to a weight management program at a Canadian paediatric tertiary care centre from November 2010 to December 2013. Participants were 209 of 217 consecutive referred paediatric patients (families) aged 3 to 17 years who met criteria for severe obesity and consented to participate. To maximize generalizability of results, there were no exclusion criteria. Primary outcomes were children's quality of life and BMI. Secondary outcomes included anxiety, depression, and non-high-density lipoprotein cholesterol levels.
The findings suggest an improvement in mental health, quality of life, and cardiometabolic health of children and adolescents of all ages over the 2 years of programming. These positive findings were consistent across gender, age, and distance to the program. BMI trajectory changes varied across age cohorts such that younger children showed more favourable outcomes. The retention rate over the 2 years was high at 82.9%.
This is the first study to show improvements in both physical and mental health outcomes beyond 1 year in a tertiary care setting with a high-risk population of children and youth with severe obesity. Findings highlight the need to examine both mental and physical health outcomes beyond 1 year.
本研究的目的是调查参加三级医疗体重管理项目的重度肥胖青少年的身心健康变化轨迹。预计年幼儿童在体重指数（BMI）、心血管健康标志物、生活质量和心理健康方面会有良好变化。
这项为期2年的纵向研究调查了2010年11月至2013年12月在加拿大一家儿科三级医疗中心被转诊至体重管理项目的儿童的健康轨迹。参与者是连续转诊的217名3至17岁儿科患者（家庭）中的209名，他们符合重度肥胖标准并同意参与。为了使结果具有最大的普遍性，没有排除标准。主要结果是儿童的生活质量和BMI。次要结果包括焦虑、抑郁和非高密度脂蛋白胆固醇水平。
研究结果表明，在为期2年的项目中，各年龄段的儿童和青少年的心理健康、生活质量和心脏代谢健康都有所改善。这些积极结果在性别、年龄和到项目地点的距离方面都是一致的。BMI轨迹变化在不同年龄组中有所不同，年幼儿童显示出更有利的结果。两年的保留率很高，为82.9%。
这是第一项显示在三级医疗环境中，针对重度肥胖的高危儿童和青少年群体，1年以上身心健康结果均有改善的研究。研究结果强调了在1年以上的时间里同时检查心理健康和身体健康结果的必要性。
