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Behavioral modification programs help obese children manage their weight

Obese school-age kids and teens can lose weight or prevent further weight gain if they participate in medium- to high-intensity behavioral management programs, according to a new report released by the Agency for Healthcare Research and Quality (AHRQ). The new report, Effectiveness of Weight Management Programs in Children and Adolescents, found that after completing weight management programs, obese children weigh between 3 pounds and 23 pounds less, on average, than obese children not involved in such programs. Among those enrolled, the weight difference is greatest among heavier children as well as in those enrolled in more intensive programs. Researchers also found that weight improvements could be maintained for up to a year after the program ended.

The report also showed that adding prescription drugs to a behavioral weight management program helped extremely obese adolescents lose weight. However, no studies evaluated maintenance of weight loss after drug treatment ended. The two primary drugs reviewed were sibutramine (Meridia®), which is an appetite suppressant, and orlistat (Xenical®), which helps block fat absorption. In one 12-month study, adolescents taking sibutramine as part of a weight management program lost an average of 14 pounds, compared with a 4.2-pound weight gain among those who took a placebo. In another trial, adolescents who took orlistat as part of their weight management program gained an average of 1.2 pounds, compared with their peers who took a placebo and gained nearly 7 pounds.

While there were no reported harms from behavioral intervention alone, there were side effects from prescription drugs. These included mild increases in heart rate or blood pressure from the use of sibutramine. Among those taking orlistat, up to one-third reported abdominal pain, oily spotting, or fecal urgency; 9 percent reported fecal incontinence.

The report, Effectiveness of Weight Management Programs in Children and Adolescents, (Publication No. 08-E014) is available at http://www.ahrq.gov/clinic/tp/chwghttp.htm and can also be ordered directly from the AHRQ Publications Clearinghouse.

Editor's Note: AHRQ also has a free DVD for families and children aged 5 to 9 called Max's Magical Delivery: Fit for Kids (Product No. 04-0088-DVD).

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