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[Conditions for success in a lifestyle intervention weight-reduction programme for overweight or obese children and adolescents].

OBJECTIVE
To analyze whether caregiver and family characteristics predict success in a family-based lifestyle intervention programme for overweight or obese children and adolescents.


METHOD
Participants were 136 overweight or obese children and adolescents (7-15 years) who attended a family-based weight-reduction programme. BMI and BMI standard deviation scores (BMI-SDS) of the index child, BMI of family members, family adversity characteristics, and depression and attachment attitudes of the primary caregiver were assessed. 116 participants finished the 12-month programme: 100 (85.3%) showed a decrease of the BMI-SDS, 79 (68.1%) a more than 5% reduction of the BMI-SDS. These "successful" children were compared to 56 "unsuccessful" ones (dropouts and children with a BMI-SDS reduction of 5% or less).


RESULTS
Failure to reduce weight considerably (≤ 5% reduction of BMI-SDS, or dropout) occurred more frequently in older children and in cases with obese sibling(s), maternal depression, and maternal avoidant attachment attitude. In a logistic regression analysis, maternal depression as well as attachment attitude, and the age of the index child explained common variance, while the presence of obese sibling(s) explained unique variance in non-responding.


CONCLUSION
Our data suggest that special support should be provided to adolescents with obese sibling(s) and to adolescents with mothers suffering from depression and exhibiting an avoidant attachment style, so as to meet the specific needs of all participating families and to prevent the discouraging experience of failure in weight-control interventions. The efficacy of these modules must be tested in further studies.