Regular medical supervision represents a fundamental component of the clinical management of
obesity. In fact, when frequently supplied it reduces the risk of failure associated with any
body weight reduction program (BWRP), resulting in
body weight gain. The aim of the present study was to establish the potential beneficial effects of increasing medical supervision on
weight loss and other auxometric and cardiometabolic parameters in a population of children and adolescents with
obesity (n = 158; F/M = 94/64; age range 9.7-17.3 years; body mass index, BMI = 37.8 ± 6.9 kg/m2), followed up for one year in a real-world setting, after and before a 3-week in-hospital BWRP.
Weight loss was significantly associated with medical supervision and changes in several auxometric and cardiometabolic parameters such as fat mass, fat-free mass, waist and hip circumferences, total and
LDL cholesterols,
triglycerides,
glucose,
insulin, HOMA-IR, systolic blood pressure and IDF criteria for the diagnosis of
metabolic syndrome. As expected,
weight loss and, congruently, medical supervision, were significantly higher in responsive and stable subjects than in those belonging to the non-responsive group and in responsive subjects than those belonging to the stable group. While
weight loss was significantly higher in subjects having class 2 and 3
obesity than those belonging to class 1
obesity group, medical supervision was significantly higher in subjects having class 3 than those having class 1
obesity.
Weight loss was significantly higher in subjects suffering from
metabolic syndrome than those without; nevertheless, no significant difference was found in medical supervision between these groups. Finally, sex was associated with no differences in
weight loss and medical supervision. In conclusion, based on the results of a real-world experience, frequent medical supervision increases the
weight loss associated with a longitudinal multidisciplinary BWRP, with a parallel improvement of a set of auxometric and cardiometabolic parameters. Prospectively, incentivising regular medical supervision should reduce the risk of BWRP failure and
body weight gain, thus contributing to counteract the detrimental transition from simple
obesity to
metabolic syndrome in pediatric patients.