Skip to main content
Top
Published in: BMC Public Health 1/2013

Open Access 01-12-2013 | Research article

Effect of the Go4it multidisciplinary group treatment for obese adolescents on health related quality of life: a randomised controlled trial

Authors: Geesje H Hofsteenge, Peter JM Weijs, Henriette A Delemarre-van de Waal, Maartje de Wit, Mai JM Chinapaw

Published in: BMC Public Health | Issue 1/2013

Login to get access

Abstract

Background

We developed a Dutch outpatient multidisciplinary group treatment (Go4it) for obese adolescents, including cognitive behavioural therapy and education on healthy dietary and physical activity behaviour. This study examined the effect of Go4it on Health Related Quality of Life (HRQoL).

Methods

At our outpatient paediatric obesity clinic, obese adolescents (n = 122, 11–18 years) were randomly assigned to 1) Go4it, 7 sessions with an interval of 2 weeks or 2) current regular care consisting of referral to a dietician in the home care setting (controls). Linear mixed model analysis was performed to evaluate the intervention effects on HRQoL at 6 and 18-month follow-ups. HRQoL indicators included the Child Health Questionnaire, the Paediatric Quality of Life Inventory™ Version 4.0 (PedsQL™4.0), and the Body Esteem Scale (BES).

Results

In total, 95 adolescents (Go4it 57, controls 38) were included in the current analysis with a mean age of 14.5 ± 1.7 and mean BMI-SDS of 2.9 ± 0.5. At baseline, all participants experienced lower levels of physical and psychosocial well-being compared to a normal weight reference group. At the 18 month follow-up, we found small but beneficial intervention effects on all subscales of the PedsQL™4.0 and BES questionnaires. Two subscales improved significantly; i.e., physical health (between group difference 5.4; 95%CI: 0.3; 10.6), and school functioning (between group difference 7.4; 95%CI: 1.6; 13.2).

Conclusion

Obese adolescents experienced lower HRQoL than their healthy peers. The Go4it intervention had small beneficial effects on HRQoL compared to the current regular care practices for obese adolescents.

Trial registration

Netherlands Trial Register: ISRCTN27626398, METC number: 05.134 (WMO, monocenter).
Appendix
Available only for authorised users
Literature
1.
go back to reference Schonbeck Y, Talma H, Van Dommelen P, Bakker B, Buitendijk SE, Hirasing RA, et al: Increase in prevalence of overweight in Dutch children and adolescents: a comparison of nationwide growth studies in 1980, 1997 and 2009. PLoS One. 2011, 6: e27608-10.1371/journal.pone.0027608.CrossRefPubMedPubMedCentral Schonbeck Y, Talma H, Van Dommelen P, Bakker B, Buitendijk SE, Hirasing RA, et al: Increase in prevalence of overweight in Dutch children and adolescents: a comparison of nationwide growth studies in 1980, 1997 and 2009. PLoS One. 2011, 6: e27608-10.1371/journal.pone.0027608.CrossRefPubMedPubMedCentral
2.
go back to reference Schwimmer JB, Burwinkle TM, Varni JW: Health-related quality of life of severely obese children and adolescents. JAMA. 2003, 289: 1813-1819. 10.1001/jama.289.14.1813.CrossRefPubMed Schwimmer JB, Burwinkle TM, Varni JW: Health-related quality of life of severely obese children and adolescents. JAMA. 2003, 289: 1813-1819. 10.1001/jama.289.14.1813.CrossRefPubMed
3.
go back to reference Dietz WH: Health consequences of obesity in youth: childhood predictors of adult disease. Pediatrics. 1998, 101: 518-525.PubMed Dietz WH: Health consequences of obesity in youth: childhood predictors of adult disease. Pediatrics. 1998, 101: 518-525.PubMed
4.
go back to reference Tsiros MD, Olds T, Buckley JD, Grimshaw P, Brennan L, Walkley J, et al: Health-related quality of life in obese children and adolescents. Int J Obes (Lond). 2009, 33: 387-400. 10.1038/ijo.2009.42.CrossRef Tsiros MD, Olds T, Buckley JD, Grimshaw P, Brennan L, Walkley J, et al: Health-related quality of life in obese children and adolescents. Int J Obes (Lond). 2009, 33: 387-400. 10.1038/ijo.2009.42.CrossRef
5.
go back to reference Zametkin AJ, Zoon CK, Klein HW, Munson S: Psychiatric aspects of child and adolescent obesity: a review of the past 10 years. J Am Acad Child Adolesc Psychiatry. 2004, 43: 134-150. 10.1097/00004583-200402000-00008.CrossRefPubMed Zametkin AJ, Zoon CK, Klein HW, Munson S: Psychiatric aspects of child and adolescent obesity: a review of the past 10 years. J Am Acad Child Adolesc Psychiatry. 2004, 43: 134-150. 10.1097/00004583-200402000-00008.CrossRefPubMed
6.
go back to reference Murphy B, Herrman H, Hawthorne G, Pinzone T, Evert H: WHOQOL-100, WHOQOL BREF and CA-WHOQOL INSTRUMENTS User’s manual and interpretaion GuideThe world health organization quality of life (WHOQOL) study. 2000, Australian: The World Health Organization Quality of Life (WHOQOL) study, Ref Type: Generic Murphy B, Herrman H, Hawthorne G, Pinzone T, Evert H: WHOQOL-100, WHOQOL BREF and CA-WHOQOL INSTRUMENTS User’s manual and interpretaion GuideThe world health organization quality of life (WHOQOL) study. 2000, Australian: The World Health Organization Quality of Life (WHOQOL) study, Ref Type: Generic
7.
go back to reference Pinhas-Hamiel O, Singer S, Pilpel N, Fradkin A, Modan D, Reichman B: Health-related quality of life among children and adolescents: associations with obesity. Int J Obes (Lond). 2006, 30: 267-272. 10.1038/sj.ijo.0803107.CrossRef Pinhas-Hamiel O, Singer S, Pilpel N, Fradkin A, Modan D, Reichman B: Health-related quality of life among children and adolescents: associations with obesity. Int J Obes (Lond). 2006, 30: 267-272. 10.1038/sj.ijo.0803107.CrossRef
8.
go back to reference Griffiths LJ, Wolke D, Page AS, Horwood JP: Obesity and bullying: different effects for boys and girls. Arch Dis Child. 2006, 91: 121-125.CrossRefPubMed Griffiths LJ, Wolke D, Page AS, Horwood JP: Obesity and bullying: different effects for boys and girls. Arch Dis Child. 2006, 91: 121-125.CrossRefPubMed
9.
go back to reference Oude Luttikhuis H, Baur L, Jansen H, Shrewsbury VA, O’Malley C, Stolk RP, et al: Interventions for treating obesity in children. Cochrane Database Syst Rev. 2009, 1: CD001872-PubMed Oude Luttikhuis H, Baur L, Jansen H, Shrewsbury VA, O’Malley C, Stolk RP, et al: Interventions for treating obesity in children. Cochrane Database Syst Rev. 2009, 1: CD001872-PubMed
10.
go back to reference Epstein LH, Valoski A, Wing RR, McCurley J: Ten-year outcomes of behavioral family-based treatment for childhood obesity. Health Psychol. 1994, 13: 373-383.CrossRefPubMed Epstein LH, Valoski A, Wing RR, McCurley J: Ten-year outcomes of behavioral family-based treatment for childhood obesity. Health Psychol. 1994, 13: 373-383.CrossRefPubMed
11.
go back to reference Wilson P, O’Meara S, Summerbell C, Kelly S: The prevention and treatment of childhood obesity. Qual Saf Health Care. 2003, 12: 65-74. 10.1136/qhc.12.1.65.CrossRefPubMedPubMedCentral Wilson P, O’Meara S, Summerbell C, Kelly S: The prevention and treatment of childhood obesity. Qual Saf Health Care. 2003, 12: 65-74. 10.1136/qhc.12.1.65.CrossRefPubMedPubMedCentral
12.
go back to reference Jelalian E, Saelens BE: Empirically supported treatments in pediatric psychology: pediatric obesity. J Pediatr Psychol. 1999, 24: 223-248. 10.1093/jpepsy/24.3.223.CrossRefPubMed Jelalian E, Saelens BE: Empirically supported treatments in pediatric psychology: pediatric obesity. J Pediatr Psychol. 1999, 24: 223-248. 10.1093/jpepsy/24.3.223.CrossRefPubMed
13.
go back to reference Savoye M, Shaw M, Dziura J, Tamborlane WV, Rose P, Guandalini C, et al: Effects of a weight management program on body composition and metabolic parameters in overweight children: a randomized controlled trial. JAMA. 2007, 297: 2697-2704. 10.1001/jama.297.24.2697.CrossRefPubMed Savoye M, Shaw M, Dziura J, Tamborlane WV, Rose P, Guandalini C, et al: Effects of a weight management program on body composition and metabolic parameters in overweight children: a randomized controlled trial. JAMA. 2007, 297: 2697-2704. 10.1001/jama.297.24.2697.CrossRefPubMed
14.
go back to reference Wille N, Erhart M, Petersen C, Ravens-Sieberer U: The impact of overweight and obesity on health-related quality of life in childhood–results from an intervention study. BMC Public Health. 2008, 8: 421-10.1186/1471-2458-8-421.CrossRefPubMedPubMedCentral Wille N, Erhart M, Petersen C, Ravens-Sieberer U: The impact of overweight and obesity on health-related quality of life in childhood–results from an intervention study. BMC Public Health. 2008, 8: 421-10.1186/1471-2458-8-421.CrossRefPubMedPubMedCentral
15.
go back to reference Vignolo M, Rossi F, Bardazza G, Pistorio A, Parodi A, Spigno S, et al: Five-year follow-up of a cognitive-behavioural lifestyle multidisciplinary programme for childhood obesity outpatient treatment. Eur J Clin Nutr. 2008, 62: 1047-1057. 10.1038/sj.ejcn.1602819.CrossRefPubMed Vignolo M, Rossi F, Bardazza G, Pistorio A, Parodi A, Spigno S, et al: Five-year follow-up of a cognitive-behavioural lifestyle multidisciplinary programme for childhood obesity outpatient treatment. Eur J Clin Nutr. 2008, 62: 1047-1057. 10.1038/sj.ejcn.1602819.CrossRefPubMed
16.
go back to reference Braet C, Tanghe A, Decaluwe V, Moens E, Rosseel Y: Inpatient treatment for children with obesity: weight loss, psychological well-being, and eating behavior. J Pediatr Psychol. 2004, 29: 519-529. 10.1093/jpepsy/jsh054.CrossRefPubMed Braet C, Tanghe A, Decaluwe V, Moens E, Rosseel Y: Inpatient treatment for children with obesity: weight loss, psychological well-being, and eating behavior. J Pediatr Psychol. 2004, 29: 519-529. 10.1093/jpepsy/jsh054.CrossRefPubMed
17.
go back to reference Hofsteenge GH, Chinapaw MJM, Weijs PJM, Van Tulder MW, Delemarre-van de Waal HA: Go4it; study design of a randomised controlled trial and economic evaluation of a multidisciplinary group intervention for obese adolescents for prevention of diabetes mellitus type 2. BMC Public Health. 2008, 8: 410-10.1186/1471-2458-8-410.CrossRefPubMedPubMedCentral Hofsteenge GH, Chinapaw MJM, Weijs PJM, Van Tulder MW, Delemarre-van de Waal HA: Go4it; study design of a randomised controlled trial and economic evaluation of a multidisciplinary group intervention for obese adolescents for prevention of diabetes mellitus type 2. BMC Public Health. 2008, 8: 410-10.1186/1471-2458-8-410.CrossRefPubMedPubMedCentral
18.
go back to reference Statistics Netherlands (www.cbs.nl): Standaarddefinitie allochtonen. 2000, Voorburg, The Netherlands: Hoe doet het CBS dat nou?, 24-25. 10 Statistics Netherlands (www.cbs.nl): Standaarddefinitie allochtonen. 2000, Voorburg, The Netherlands: Hoe doet het CBS dat nou?, 24-25. 10
20.
go back to reference Cole TJ, Bellizzi MC, Flegal KM, Dietz WH: Establishing a standard definition for child overweight and obesity worldwide: international survey. BMJ. 2000, 320: 1240-1243. 10.1136/bmj.320.7244.1240.CrossRefPubMedPubMedCentral Cole TJ, Bellizzi MC, Flegal KM, Dietz WH: Establishing a standard definition for child overweight and obesity worldwide: international survey. BMJ. 2000, 320: 1240-1243. 10.1136/bmj.320.7244.1240.CrossRefPubMedPubMedCentral
21.
go back to reference Epstein LH, Myers MD, Raynor HA, Saelens BE: Treatment of pediatric obesity. Pediatrics. 1998, 101: 554-570.PubMed Epstein LH, Myers MD, Raynor HA, Saelens BE: Treatment of pediatric obesity. Pediatrics. 1998, 101: 554-570.PubMed
22.
go back to reference Singh AS, Chinapaw MJM, Kremers SPJ, Visscher TLS, Brug J, Mechelen van W: Design of the dutch obesity intervention in teenagers (NRG-DOiT): systematic development, implementation and evaluation of a school-based intervention aimed at the prevention of excessive weight gain in adolescents. BMC Public Health. 2006, 6: 304-10.1186/1471-2458-6-304.CrossRefPubMedPubMedCentral Singh AS, Chinapaw MJM, Kremers SPJ, Visscher TLS, Brug J, Mechelen van W: Design of the dutch obesity intervention in teenagers (NRG-DOiT): systematic development, implementation and evaluation of a school-based intervention aimed at the prevention of excessive weight gain in adolescents. BMC Public Health. 2006, 6: 304-10.1186/1471-2458-6-304.CrossRefPubMedPubMedCentral
23.
go back to reference Varni JW, Seid M, Kurtin PS: PedsQL 4.0: reliability and validity of the pediatric quality of life inventory version 4.0 Generic core scales in healthy and patient populations. Med Care. 2001, 39: 800-812. 10.1097/00005650-200108000-00006.CrossRefPubMed Varni JW, Seid M, Kurtin PS: PedsQL 4.0: reliability and validity of the pediatric quality of life inventory version 4.0 Generic core scales in healthy and patient populations. Med Care. 2001, 39: 800-812. 10.1097/00005650-200108000-00006.CrossRefPubMed
24.
go back to reference Varni JW, Seid M, Knight TS, Uzark K, Szer IS: The PedsQL 4.0 Generic core scales: sensitivity, responsiveness, and impact on clinical decision-making. J Behav Med. 2002, 25: 175-193. 10.1023/A:1014836921812.CrossRefPubMed Varni JW, Seid M, Knight TS, Uzark K, Szer IS: The PedsQL 4.0 Generic core scales: sensitivity, responsiveness, and impact on clinical decision-making. J Behav Med. 2002, 25: 175-193. 10.1023/A:1014836921812.CrossRefPubMed
25.
go back to reference Landgraf JM, Abetz L, Ware JE: The CHQ User’s Manual. 1996, Boston: The Health Institute, New England Medical Center Landgraf JM, Abetz L, Ware JE: The CHQ User’s Manual. 1996, Boston: The Health Institute, New England Medical Center
26.
go back to reference Engelen V, Haentjens MM, Detmar SB, Koopman HM, Grootenhuis MA: Health related quality of life of Dutch children: psychometric properties of the PedsQL in the Netherlands. BMC Pediatr. 2009, 9: 68-10.1186/1471-2431-9-68.CrossRefPubMedPubMedCentral Engelen V, Haentjens MM, Detmar SB, Koopman HM, Grootenhuis MA: Health related quality of life of Dutch children: psychometric properties of the PedsQL in the Netherlands. BMC Pediatr. 2009, 9: 68-10.1186/1471-2431-9-68.CrossRefPubMedPubMedCentral
27.
go back to reference Raat H, Landgraf JM, Bonsel GJ, Gemke RJBJ, Essink-Bot ML: Reliability and validity of the child health questionnaire-child form (CHQ-CF87) in a Dutch adolescent population. Qual Life Res. 2002, 11: 575-581. 10.1023/A:1016393311799.CrossRefPubMed Raat H, Landgraf JM, Bonsel GJ, Gemke RJBJ, Essink-Bot ML: Reliability and validity of the child health questionnaire-child form (CHQ-CF87) in a Dutch adolescent population. Qual Life Res. 2002, 11: 575-581. 10.1023/A:1016393311799.CrossRefPubMed
28.
go back to reference Mendelson BK, Mendelson MJ, White DR: Body-esteem scale for adolescents and adults. J Pers Assess. 2001, 76: 90-106. 10.1207/S15327752JPA7601_6.CrossRefPubMed Mendelson BK, Mendelson MJ, White DR: Body-esteem scale for adolescents and adults. J Pers Assess. 2001, 76: 90-106. 10.1207/S15327752JPA7601_6.CrossRefPubMed
29.
go back to reference Nakagawa S, Cuthill IC: Effect size, confidence interval and statistical significance: a practical guide for biologists. Biol Rev Camb Philos Soc. 2007, 82: 591-605. 10.1111/j.1469-185X.2007.00027.x.CrossRefPubMed Nakagawa S, Cuthill IC: Effect size, confidence interval and statistical significance: a practical guide for biologists. Biol Rev Camb Philos Soc. 2007, 82: 591-605. 10.1111/j.1469-185X.2007.00027.x.CrossRefPubMed
30.
go back to reference Cohen J: Statistical power analysis. Current directions in psychological science 1[3]. 1992, New York: Association for Psychological Science, 98-101. Cohen J: Statistical power analysis. Current directions in psychological science 1[3]. 1992, New York: Association for Psychological Science, 98-101.
31.
go back to reference Hofsteenge GH, Chinapaw MJM, Delemarre-van de Waal HA, Weijs PJM: Long-term effect of the Go4it group treatment for obese adolescents: a randomised controlled trial. Clin Nutr. 2013, In press Hofsteenge GH, Chinapaw MJM, Delemarre-van de Waal HA, Weijs PJM: Long-term effect of the Go4it group treatment for obese adolescents: a randomised controlled trial. Clin Nutr. 2013, In press
32.
go back to reference De Beer M, Hofsteenge GH, Koot HM, Hirasing RA, Delemarre-van de Waal HA, Gemke RJ: Health-related-quality-of-life in obese adolescents is decreased and inversely related to BMI. Acta Paediatr. 2007, 96: 710-714. 10.1111/j.1651-2227.2007.00243.x.CrossRefPubMed De Beer M, Hofsteenge GH, Koot HM, Hirasing RA, Delemarre-van de Waal HA, Gemke RJ: Health-related-quality-of-life in obese adolescents is decreased and inversely related to BMI. Acta Paediatr. 2007, 96: 710-714. 10.1111/j.1651-2227.2007.00243.x.CrossRefPubMed
33.
go back to reference Varni JW, Limbers CA, Burwinkle TM: Impaired health-related quality of life in children and adolescents with chronic conditions: a comparative analysis of 10 disease clusters and 33 disease categories/severities utilizing the PedsQL 4.0 Generic core scales. Health Qual Life Outcomes. 2007, 5: 43-10.1186/1477-7525-5-43.CrossRefPubMedPubMedCentral Varni JW, Limbers CA, Burwinkle TM: Impaired health-related quality of life in children and adolescents with chronic conditions: a comparative analysis of 10 disease clusters and 33 disease categories/severities utilizing the PedsQL 4.0 Generic core scales. Health Qual Life Outcomes. 2007, 5: 43-10.1186/1477-7525-5-43.CrossRefPubMedPubMedCentral
34.
go back to reference Van Vlierberghe L, Braet C, Goossens L, Mels S: Psychiatric disorders and symptom severity in referred versus non-referred overweight children and adolescents. Eur Child Adolesc Psychiatry. 2009, 18: 164-173. 10.1007/s00787-008-0717-5.CrossRefPubMed Van Vlierberghe L, Braet C, Goossens L, Mels S: Psychiatric disorders and symptom severity in referred versus non-referred overweight children and adolescents. Eur Child Adolesc Psychiatry. 2009, 18: 164-173. 10.1007/s00787-008-0717-5.CrossRefPubMed
35.
go back to reference Steinsbekk S, Jozefiak T, Odegard R, Wichstrom L: Impaired parent-reported quality of life in treatment-seeking children with obesity is mediated by high levels of psychopathology. Qual Life Res. 2009, 18: 1159-1167. 10.1007/s11136-009-9535-6.CrossRefPubMed Steinsbekk S, Jozefiak T, Odegard R, Wichstrom L: Impaired parent-reported quality of life in treatment-seeking children with obesity is mediated by high levels of psychopathology. Qual Life Res. 2009, 18: 1159-1167. 10.1007/s11136-009-9535-6.CrossRefPubMed
36.
go back to reference Jelalian E, Mehlenbeck R, Lloyd-Richardson EE, Birmaher V, Wing RR: 'Adventure therapy’ combined with cognitive-behavioral treatment for overweight adolescents. Int J Obes (Lond). 2006, 30: 31-39. 10.1038/sj.ijo.0803069.CrossRef Jelalian E, Mehlenbeck R, Lloyd-Richardson EE, Birmaher V, Wing RR: 'Adventure therapy’ combined with cognitive-behavioral treatment for overweight adolescents. Int J Obes (Lond). 2006, 30: 31-39. 10.1038/sj.ijo.0803069.CrossRef
37.
go back to reference Saelens BE, Sallis JF, Wilfley DE, Patrick K, Cella JA, Buchta R: Behavioral weight control for overweight adolescents initiated in primary care. Obes Res. 2002, 10: 22-32. 10.1038/oby.2002.4.CrossRefPubMed Saelens BE, Sallis JF, Wilfley DE, Patrick K, Cella JA, Buchta R: Behavioral weight control for overweight adolescents initiated in primary care. Obes Res. 2002, 10: 22-32. 10.1038/oby.2002.4.CrossRefPubMed
38.
go back to reference Wadden TA, Stunkard AJ, Rich L, Rubin CJ, Sweidel G, McKinney S: Obesity in black adolescent girls: a controlled clinical trial of treatment by diet, behavior modification, and parental support. Pediatrics. 1990, 85: 345-352.PubMed Wadden TA, Stunkard AJ, Rich L, Rubin CJ, Sweidel G, McKinney S: Obesity in black adolescent girls: a controlled clinical trial of treatment by diet, behavior modification, and parental support. Pediatrics. 1990, 85: 345-352.PubMed
39.
go back to reference Williamson DA, Martin PD, White MA, Newton R, Walden H, York-Crowe E, et al: Efficacy of an internet-based behavioral weight loss program for overweight adolescent African-American girls. Eat Weight Disord. 2005, 10: 193-203. 10.1007/BF03327547.CrossRefPubMed Williamson DA, Martin PD, White MA, Newton R, Walden H, York-Crowe E, et al: Efficacy of an internet-based behavioral weight loss program for overweight adolescent African-American girls. Eat Weight Disord. 2005, 10: 193-203. 10.1007/BF03327547.CrossRefPubMed
Metadata
Title
Effect of the Go4it multidisciplinary group treatment for obese adolescents on health related quality of life: a randomised controlled trial
Authors
Geesje H Hofsteenge
Peter JM Weijs
Henriette A Delemarre-van de Waal
Maartje de Wit
Mai JM Chinapaw
Publication date
01-12-2013
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2013
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/1471-2458-13-939

Other articles of this Issue 1/2013

BMC Public Health 1/2013 Go to the issue