Meta-analyses and systematic reviews of multi-disciplinary intervention programmes for child and adolescent obesity have shown they lead to clinically significant improvements in weight and cardio-metabolic outcomes in the short to medium term.1,2 New Zealand Ministry of Health guidelines currently support a multi-disciplinary approach to child and adolescent obesity, but very few of these programmes exist nationally.3
Aim: To determine the effectiveness of current interventions in New Zealand in obese children and adolescents accessing either a standard model of care (medical input alone or with the addition of dietitian and physical activity input), or one of the country’s long-standing multi-disciplinary intervention programmes.
Methods: Data were collected from 290 patients across four centres in New Zealand who manage obese and overweight children and adolescents aged 3-16 years in Paediatric clinics. Ethnicity, gender, height, weight and nature of intervention over medical assessments spanning an average of 2.1 years from baseline were collected. Body Mass Index (BMI), BMI percentile and BMI standard deviation score (SDS) were then calculated.
Results: There was a small but significant annual reduction in BMI SDS irrespective of the nature of intervention (-0.15 overall). There was no significant difference in BMI SDS between interventions. The extent of BMI SDS reduction decreased with increasing age at first outpatient attendance (p=0.0006). BMI SDS reduction was unaffected by ethnicity or gender.
Conclusions: Mild reductions in BMI SDS are achievable in children being referred to and managed for obesity by a range of models. It is important that paediatricians are proactive in identifying and addressing obesity with families. Further research is required to evaluate multi-disciplinary intervention programmes, and how their effectiveness can be increased, given their recognised benefits in improving weight and cardio-metabolic profile.