Out patient program for obesity in childhood (T.O.M.)

Since 1997 164 obese children aged 8 to 17 years have been participating together with their parents in our outpatient program (T.O.M.) The treatment of obesity includes different physical activities 3 times/week, education in nutrition and behavior by a nutritionist and psychologist with current healthy eating guidelines. The goal is to maintain or slightly reduce body weight, to learn self-monitoring, self-control and longterm evaluation of their individual concept on their daily base. After one-year of intensive education the children booster sesscion take place once a month during the second year and twice in the third year. It was shown that 76,2% of obese children suffer from metabolic risk factors like lipid profile and fibrinogen. Echocardiography revealed normal cardiac dimensions (L V muscle mass 66 plus or minus 11 g/m super(2)). In spirometry maximal work load was 2,0 plus or minus 0,4 W/kg body weight, after 1 year 2,5 plus or minus 0,4 W/kg. The ventilatory anaerob theshold was reached at work load 1,2 plus or minus 0,3 W/kg after 3: 45 plus or minus 0,9 minutes of exercise (after 1 year 1,6 plus or minus 0,3 after 5: 30 plus or minus 1,3 minutes). The percent overweight > 97 + 10,6 plus or minus 4,4 kg/cm super(2) was reduced to > 97 + 5,8 plus or minus 4,6 kg/cm super(2). Before 1 year treatment the average of skinfold thickness was scapular 30,4 plus or minus 11,2 mm (after 25,7 plus or minus 8,9), biceps 15,2 plus or minus 5,9 mm, (after 13,8 plus or minus 7,1 mm), triceps 28,2 plus or minus 8,7 mm (after 24,4 plus or minus 6,9 mm) abdomen 38,2 plus or minus 11,5 mm (after 31,8 plus or minus 9,4 mm). After 12 months of interdisciplinary intervention we found an increase of 50% in Bahnenschwimmen, during fitness exercise the children could increase their work load from 100 - 122 Watt and from 10 to 14:30 minutes. The average of lactate level was 2,75 mmol/l during physical activity.