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Obese Children Suffer Like Cancer Kids

Behavior Therapy/Weight-Loss Drug may Help Some Teens

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Younger children suffered just as much as teens. Race, ethnicity, and cultural factors didn't make any difference. No matter the cultural background, obesity devastated kids' quality of life.

It's not at all clear what to do about childhood obesity. Intensive behavioral therapy can help. Unfortunately, Schwimmer notes, this is the kind of care that insurance companies are least likely to pay for.

"The best treatment includes physicians, dieticians, and mental health professionals working together as a team," he says. "Insurance companies tend not to pay for many of those services. It is a real limiting factor. They pay for complications such as diabetes, orthopedic procedures, liver disease, and sleep apnea. But those are all caused by extra body fat. If that is made better, many other problems will be made better."

Might treatment improve life quality for these kids? Schwimmer is now studying the issue. But there's already some preliminary evidence that it does. Robert I. Berkowitz, MD, is medical director of the University of Pennsylvania's weight and eating disorders program. He's lead researcher of a study that looked at treating obese teens with intensive behavioral therapy, with or without the diet drug Meridia.

"When it comes to body image concerns, these kids have lots of problems," Berkowitz tells WebMD. "We saw that overall, mood and self-esteem improves with this kind of support. Quality of life and body image improves with treatment and may not correlate with weight loss. With a lot of support, teens felt better about themselves. It's not easy to be an overweight teen in our culture. These kids really have it tough. We like to think it is helping the kids' self-esteem as well as their health."

All of the teens in the Berkowitz study got intensive, family-based behavior therapy. Dietitians, psychologists, or psychiatrists lead each session. This state-of-the-art therapy starts with 13 weekly group sessions followed by six every-other-week sessions. After this, treatment tapers off to two more months of biweekly sessions and three monthly sessions. That's not all: Parent groups meet separately on the same schedule.

This helped kids lose some weight. Ranging in age from 13 to 17, the teens started with an average weight of 228 pounds. After six months of behavior therapy, kids lost an average of seven pounds.

But if kids got Meridia as well as behavioral therapy, they lost twice as much weight. And over the next six months they kept most of this weight off. When kids started taking Meridia after six months of behavior therapy alone, they lost another three pounds. Meridia's manufacturer, Abbott Laboratories, provided the Meridia for the study.

"Forty percent of the kids on [Meridia] lost 10% or more of their weight. With behavior therapy alone, only 15% of kids lost 10% or more of their weight," Berkowitz says. "Ninety percent of health benefits come from the first 10% of weight loss. So 10% is a pretty realistic goal, and many of the health benefits are gained there."

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