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Development and Implementation of a Pilot Integrative Day Hospital Program for Youth with Severe Obesity and Mental Health Issues.
Dettmer, Elizabeth; Grewal, Seena; Regina, Andrea; Phung, Natalie; Steinegger, Cathleen; Hamilton, Jill; Toulany, Alene.
Afiliación
  • Dettmer E; Department of Pediatrics and University of Toronto Faculty of Medicine, Toronto, Ontario, Canada.
  • Grewal S; Department of Psychology and The Hospital for Sick Children, Toronto, Ontario, Canada.
  • Regina A; Department of Psychiatry, University of Toronto Faculty of Medicine, Toronto, Ontario, Canada.
  • Phung N; Department of Psychiatry, The Hospital for Sick Children, Toronto, Ontario, Canada.
  • Steinegger C; Department of Psychology and The Hospital for Sick Children, Toronto, Ontario, Canada.
  • Hamilton J; Divisions of Adolescent Medicine and Department of Pediatrics, The Hospital for Sick Children, Toronto, Ontario, Canada.
  • Toulany A; Department of Pediatrics and University of Toronto Faculty of Medicine, Toronto, Ontario, Canada.
Child Obes ; 17(8): 563-572, 2021 12.
Article en En | MEDLINE | ID: mdl-34542323
ABSTRACT

Background:

Adolescents with severe obesity and comorbid mental health issues are the most resistant to traditional weight management approaches and have poor treatment outcomes. Our objective was to implement and evaluate a pilot day hospital treatment program for adolescents with severe obesity, or risk for severe obesity, and significant mental health comorbidities.

Methods:

This was a prospective cohort study of adolescents 12-18 years of age with severe obesity (BMI >99th percentile), or at risk for severe obesity, and comorbid mental health issues. The intervention, focused on healthy lifestyle and mental health support, was implemented within an existing psychiatric day hospital at a pediatric quaternary care hospital. Anthropometric and mental health measures were analyzed pre- and postintervention.

Results:

Thirty-two adolescents with a mean age of 14.9 years [standard deviation (SD) 1.6] participated in the pilot integrative day hospital program for a mean duration of 5.2 months (SD 2.3). Eleven participants had primary severe obesity and comorbid mental health conditions (obesity subgroup) and 21 participants had primary mental illness and were at risk for obesity (psychiatry subgroup). We did not observe a significant difference between BMI pre- and postprogram among adolescents in both subgroups. In other words, adolescents in both subgroups achieved weight maintenance. Fear in losing control of overeating and/or being seen by others when eating decreased significantly in the obesity subgroup [mean difference (MD) 0.99; 95% confidence interval (CI) 0.27 to 1.71]. There was a significant decrease in participant-reported depression symptom severity, both overall and within program subgroups. Quality-of-life scores of study participants improved significantly within the obesity subgroup (MD -12.31; 95% CI -21.69 to -2.93), but not within the psychiatry subgroup (MD -6.35; 95% CI -13.37 to 0.67). Conclusions and Implications A day hospital model of care may result in weight maintenance, decreased eating concerns, and improved mental health in adolescents with severe obesity or risk for severe obesity, and significant mental health comorbidities.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Obesidad Mórbida / Obesidad Infantil Tipo de estudio: Observational_studies / Prognostic_studies / Sysrev_observational_studies Aspecto: Implementation_research / Patient_preference Límite: Adolescent / Child / Humans Idioma: En Revista: Child Obes Año: 2021 Tipo del documento: Article País de afiliación: Canadá

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Obesidad Mórbida / Obesidad Infantil Tipo de estudio: Observational_studies / Prognostic_studies / Sysrev_observational_studies Aspecto: Implementation_research / Patient_preference Límite: Adolescent / Child / Humans Idioma: En Revista: Child Obes Año: 2021 Tipo del documento: Article País de afiliación: Canadá