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  • Proceedings of the Nutrition Society, Volume 70, Issue 4
  • November 2011, pp. 494-505

Effectiveness of lifestyle intervention in overweight children

  • Thomas Reinehr (a1)
  • DOI:
  • Published online: 01 August 2011

Therapy of choice in obese children and adolescents is lifestyle intervention based on nutrition education, behavioural treatment and exercise treatment. Its efficacy even after the end of intervention has been proven by several randomised-controlled trials and meta-analyses including a recent Cochrane review. However, randomised-controlled trials are likely to overestimate the effectiveness. Studies under normal day-to-day circumstances demonstrated only a very moderate effect on weight loss (<10% success rate 2 years after the onset of intervention). A reduction of >0·5 SDS-BMI (which means a stable weight over 1 year in growing children) is associated with an improvement of cardiovascular risk factors, while improvements of quality of life seem independent of the degree of weight loss. Younger children and less overweight children particularly profit from lifestyle interventions in contrast to extremely obese adolescents. Recent studies demonstrated that involving parents is crucial for success, suggesting that parents and children and not children alone should be the primary target of interventions. Failures in weight reduction are attributed not only to a lack of motivation but also to other aspects particular to the genetic background. The techniques, more than the contents, of an intervention influence the treatment outcome. Besides behavioural therapy, systemic and solution-focused treatments are important. Future longitudinal research should focus on the identification of which children and adolescents profit from which kind of intervention, in order to be able to tailor specific treatment approaches. Studies under normal day-to-day circumstances are necessary to prove the benefit of this kind of intervention.

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Corresponding author: Professor Thomas Reinehr, fax +49 2363 975 218, email:
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1.CB Ebbeling , DB Pawlak & DS Ludwig (2002) Childhood obesity: public-health crisis, common sense cure. Lancet 360, 473482.

2.B Livingstone (2000) Epidemiology of childhood obesity in Europe. Eur J Pediatr 159, Suppl 1, S14S34.

3.RC Whitaker , JA Wright , MS Pepe . (1997) Predicting obesity in young adulthood from childhood and parental obesity. N Engl J Med 337, 869873.

4.D I'Allemand , S Wiegand , T Reinehr . (2008) Cardiovascular risk in 26 008 European overweight children as established by a multicenter database. Obesity (Silver Spring) 16, 16721679.

5.T Reinehr (2005) Clinical presentation of type 2 diabetes mellitus in children and adolescents. Int J Obes (Lond) 29, Suppl 2, S105S110.

6.JL Baker , LW Olsen & TI Sorensen (2007) Childhood body-mass index and the risk of coronary heart disease in adulthood. N Engl J Med 357, 23292337.

7.FM Biro & M Wien (2010) Childhood obesity and adult morbidities. Am J Clin Nutr 91, 1499S1505S.

8.T Reinehr , W Kiess , G de Sousa . (2006) Intima media thickness in childhood obesity: Relations to inflammatory marker, glucose metabolism, and blood pressure. Metabolism 55, 113118.

9.MW Lorenz , HS Markus , ML Bots . (2007) Prediction of clinical cardiovascular events with carotid intima-media thickness: A systematic review and meta-analysis. Circulation 115, 459467.

10.PW Franks , RL Hanson , WC Knowler . (2010) Childhood obesity, other cardiovascular risk factors, and premature death. N Engl J Med 362, 485493.

15.T Reinehr , RW Holl & M Wabitsch (2008) The German working group of obesity in childhood and adolescence (AGA): Improving the quality of care for overweight and obese children in Germany. Obes Facts 1, 2632.

17.T Reinehr (2010) Obesity and thyroid function. Mol Cell Endocrinol 316, 165171.

18.CL Roth & T Reinehr (2010) Roles of gastrointestinal and adipose tissue peptides in childhood obesity and changes after weight loss due to lifestyle intervention. Arch Pediatr Adolesc Med 164, 131138.

19.N Wille , M Bullinger , R Holl . (2010) Health-related quality of life in overweight and obese youths: results of a multicenter study. Health Qual Life Outcomes 8, 36.

20.U Hoffmeister , M Bullinger , A van Egmond-Fröhlich . (2011) Übergewicht und Adipositas in Kindheit und Jugend: Evaluation der ambulanten und stationären Versorgung in Deutschland in der “EvAKuJ-Studie”. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 54, 603610.

21.T Reinehr , W Kiess , T Kapellen . (2004) Insulin sensitivity among obese children and adolescents, according to degree of weight loss. Pediatrics 114, 15691573.

22.T Reinehr & W Andler (2004) Changes in the atherogenic risk factor profile according to degree of weight loss. Arch Dis Child 89, 419422.

23.T Reinehr , M Kleber & AM Toschke (2009) Lifestyle intervention in obese children is associated with a decrease of the metabolic syndrome prevalence. Atherosclerosis 207, 174180.

24.V Martinez , AF Salcedo , GR Franquelo . (2008) Assessment of an after-school physical activity program to prevent obesity among 9- to 10-year-old children: a cluster randomized trial. Int J Obes (Lond) 32, 1222.

25.K Bös , J Heel , N Romahn . (2010) Untersuchungen zur Motorik im Rahmen des Kinder- und Jugendsurveys. Gesundheitswesen 64, 8087.

26.L Monasta , GD Batty , A Macaluso . (2010) Interventions for the prevention of overweight and obesity in preschool children: a systematic review of randomized controlled trials. Obes Rev 12, e107e118.

27.T Reinehr , K Brylak , U Alexy . (2003) Predictors to success in outpatient training in obese children and adolescents. Int J Obes Relat Metab Disord 27, 10871092.

29.LH Epstein , JN Roemmich , JL Robinson . (2008) A randomized trial of the effects of reducing television viewing and computer use on body mass index in young children. Arch Pediatr Adolesc Med 162, 239245.

30.J James , P Thomas & D Kerr (2007) Preventing childhood obesity: two year follow-up results from the Christchurch obesity prevention programme in schools (CHOPPS). Br Med J 335, 762.

31.R Muckelbauer , L Libuda , K Clausen , . (2009) Promotion and provision of drinking water in schools for overweight prevention: randomized, controlled cluster trial. Pediatrics 123, e661e667.

32.R Muckelbauer , L Libuda , K Clausen . (2009) A simple dietary intervention in the school setting decreased incidence of overweight in children. Obes Facts 2, 282285.

33.MA Pereira , AI Kartashov , CB Ebbeling . (2005) Fast-food habits, weight gain, and insulin resistance (the CARDIA study): 15-year prospective analysis. Lancet 365, 3642.

34.B Gutin (2008) Child obesity can be reduced with vigorous activity rather than restriction of energy intake. Obesity (Silver Spring) 16, 21932196.

35.SM Phillips , LG Bandini , EN Naumova . (2004) Energy-dense snack food intake in adolescence: longitudinal relationship to weight and fatness. Obes Res 12, 461472.

36.T Reinehr , DM Kersting , C Chahda . (2001) Nutritional knowledge of obese and nonobese children. J Pediatr Gastroenterol Nutr 33, 351.

37.CE Flodmark (2005) Management of the obese child using psychological-based treatments. Acta Paediatr Suppl 94, 1422.

38.LH Epstein , A Valoski , RR Wing . (1994) Ten-year outcomes of behavioral family-based treatment for childhood obesity. Health Psychol 13, 373383.

39.LH Epstein , JN Roemmich & HA Raynor (2001) Behavioral therapy in the treatment of pediatric obesity. Pediatr Clin North Am 48, 981993.

40.MA Kalarchian , MD Levine , SA Arslanian . (2009) Family-based treatment of severe pediatric obesity: randomized, controlled trial. Pediatrics 124, 10601068.

41.DL Katz , M O'Connell , VY Njike . (2008) Strategies for the prevention and control of obesity in the school setting: systematic review and meta-analysis. Int J Obes (Lond) 32, 17801789.

42.L McGovern , JN Johnson , R Paulo . (2008) Clinical review: treatment of pediatric obesity: A systematic review and meta-analysis of randomized trials. J Clin Endocrinol Metab 93, 46004605.

43.AM Magarey , RA Perry , LA Baur . (2011) A parent-led family-focused treatment program for overweight children aged 5 to 9 years: The PEACH RCT. Pediatrics 127, 214222.

44.AD Okely , CE Collins , PJ Morgan . (2010) Multi-site randomized controlled trial of a child-centered physical activity program, a parent-centered dietary-modification program, or both in overweight children: the HIKCUPS study. J Pediatr 157, 388394.

45.T Reinehr , U Hoffmeister , R Mann . (2009) Medical care of overweight children under real-life conditions: the German BZgA observation study. Int J Obes (Lond) 33, 418423.

46.T Reinehr & M Wabitsch (2003) Treatment of obese children and adolescents in Germany. J Pediatr Gastroenterol Nutr 37, 208.

48.T Reinehr , A Schaefer , K Winkel . (2010) An effective lifestyle intervention in overweight children: Findings from a randomized controlled trial on “Obeldicks light”. Clin Nutr 29, 331336.

49.T Reinehr , M Kersting , U Alexy . (2003) Long-term follow-up of overweight children: After training, after a single consultation session, and without treatment. J Pediatr Gastroenterol Nutr 37, 7274.

51.T Reinehr , E Schober , CL Roth . (2008) Type 2 diabetes in children and adolescents in a 2-year follow-up: insufficient adherence to diabetes centers. Horm Res 69, 107113.

52.G Grinstein , R Muzumdar , L Aponte . (2003) Presentation and 5-year follow-up of type 2 diabetes mellitus in African–American and Caribbean–Hispanic adolescents. Horm Res 60, 121126.

53.C Denzer , E Reithofer , M Wabitsch . (2004) The outcome of childhood obesity management depends highly upon patient compliance. Eur J Pediatr 163, 99–104.

54.T Reinehr , G de Sousa & W Andler (2005) Longitudinal analyses among overweight, insulin resistance, and cardiovascular risk factors in children. Obes Res 13, 18241833.

55.SL Gortmaker , A Must , JM Perrin . (1993) Social and economic consequences of overweight in adolescence and young adulthood. N Engl J Med 329, 10081012.

56.J de Niet , R Timman , M Jongejan . (2011) Predictors of participant dropout at various stages of a pediatric lifestyle program. Pediatrics 127, e164e170.

57.BM Kurth & RA Schaffrath (2007) The prevalence of overweight and obese children and adolescents living in Germany. Results of the German Health Interview and Examination Survey for Children and Adolescents (KiGGS). Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 50, 736743.

58.R Muckelbauer , L Libuda , K Clausen . (2010) Immigrational background affects the effectiveness of a school-based overweight prevention program promoting water consumption. Obesity (Silver Spring) 18, 528534.

59.U Hoffmeister , M Bullinger , AV Egmond-Frohlich . (2010) Treatment of obesity in pediatric patients in Germany: anthropometry, comorbidity and socioeconomic gradients based on the BZgA observational study. Klin Padiatr 222, 274278.

60.ML Fitzgibbon , MR Stolley , L Schiffer , . (2006) Hip-Hop to health Jr. for latino preschool children. Obesity (Silver Spring) 14, 16161625.

61.ML Fitzgibbon , MR Stolley , L Schiffer . (2010) Obesity reduction black intervention trial (ORBIT): 18-month results. Obesity (Silver Spring) 18, 23172325.

62.ML Fitzgibbon , MR Stolley , LA Schiffer . (2010) Hip-Hop to health Jr. obesity prevention effectiveness trial: postintervention results. Obesity (Silver Spring) 19, 994–1003.

63.A Hinney , CI Vogel & J Hebebrand (2010) From monogenic to polygenic obesity: Recent advances. Eur Child Adolesc Psychiatry 19, 297310.

64.T Reinehr , J Hebebrand , S Friedel . (2009) Lifestyle intervention in obese children with variations in the melanocortin 4 receptor gene. Obesity (Silver Spring) 17, 382389.

65.T Reinehr , A Hinney , TT Nguyen . (2008) Evidence of an influence of a polymorphism near the INSIG2 on weight loss during a lifestyle intervention in obese children and adolescents. Diabetes 57, 623626.

66.T Reinehr , A Hinney , A Toschke . (2009) Aggravating effect of INSIG2 and FTO on overweight reduction in a one-year lifestyle intervention. Arch Dis Child 94, 965967.

67.TD Muller , A Hinney , A Scherag . (2008) ‘Fat mass and obesity associated’ gene (FTO): no significant association of variant rs9939609 with weight loss in a lifestyle intervention and lipid metabolism markers in German obese children and adolescents. BMC Med Genet 9, 85.

68.T Reinehr , S Friedel , TD Mueller . (2008) Evidence for an influence of TCF7L2 polymorphism rs7903146 on insulin resistance and sensitivity indices in overweight children and adolescents during a lifestyle intervention. Int J Obes (Lond) 32, 15211524.

69.T Reinehr , M Kleber , G de Sousa . (2009) Leptin concentrations are a predictor of overweight reduction in a lifestyle intervention. Int J Pediatr Obes 4, 19.

70.T Reinehr , M Kersting , A Wollenhaupt . (2005) Evaluation of the training program “OBELDICKS” for obese children and adolescents. Klin Padiatr 217, 18.

73.T Reinehr , M Temmesfeld , M Kersting . (2007) Four-year follow-up of children and adolescents participating in an obesity intervention program. Int J Obes (Lond) 31, 10741077.

74.T Reinehr , M Kleber , N Lass . (2010) Body mass index patterns over 5 y in obese children motivated to participate in a 1-y lifestyle intervention: age as a predictor of long-term success. Am J Clin Nutr 91, 11651171.

75.R Wunsch , G de Sousa , AM Toschke . (2006) Intima-media thickness in obese children before and after weight loss. Pediatrics 118, 23342340.

76.E Finne , T Reinehr , A Schaefer . (2009) Overweight children and adolescents–is there a subjective need for treatment? Int J Public Health 54, 112116.

78.M Kleber , A Schaefer , K Winkel . (2009) Lifestyle intervention “Obeldicks Mini” for obese children aged 4 to 7 years. Klin Padiatr 221, 290294.

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