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The prevalence of obesity in children has increased dramatically during the past decades, and requires efficient care. Objectives. -To determine changes in anthropometric parameters and basal metabolic rate (BMR) in obese adolescents during and after 2 types of weight-reduction programs. Subjects and methods. -Twenty-six adolescents (group I, Z-score of BMI=4.72) followed a 9-month-weight reduction program including a moderate energy restriction and regular physical activities in a specialized institution. In addition, 39 adolescents (group E, Z-score of BMI=2.83) followed at home a 9-month-weight reduction program including medical and dietetic advices. Body composition (by impedancemetry) and BMR (by indirect calorimetry) were assessed before the beginning (M0), 4 months after (M4) and at the end (M9) of the programs, then 4 months (M13) and 16 month (M25) after the end of the weight-reduction programs. Results. -Twenty-two adolescents in group I and 20 adolescents in group E completed the study. At M0, age, body weight (BW), fat-free mass (FFM)-and BMR of subjects of group I were higher (1.0 year, 36 % , 30 % and 23 % , respectively, P < 0.001), than those of group E. Pubertal stage and percentage of fat mass (FM) were not significantly different between the 2 groups. At M9, adolescents of group I showed significant reductions in BW and FM (-19 and -37 % , respectively, P< 0.001), but not significant differences in FFM. In addition, BMR decreased significantly between M0 and M4, both in absolute value (-6.7% , P< 0.001) and after adjustment for FFM (-5.8% , P< 0.001), and the difference was maintained until M9. Between M9 and M13,BW and Z-sc-ore of BMI were maintained in 12 adolescents, but increased (+ 9.7% and 14.8% , respectively, P< 0.001) in 10 adolescents. However, BMR did not change significantly in all adolescents. Between M13 and M25, BW, FM, FFM and BMR increased significantly (+ 13% , + 34% , + 6% et + 5% , respectively, P< 0.001). During the 25 month period, adolescents of group E showed significant increases in BW, FFM and BMR (+ 8% , + 14% and + 10% , respectively, P< 0.001), and maintained their Z-score and FM. Conclusion. -The reduction in BMR during the weight-reduction program at the institution could contribute to body weight regain in the post-obese adolescents if they do not maintain the lifestyle habits taught during the weight-reduction period. In other respects, Z-score was stabilized in 51% of domiciled obese adolescents.
Objectives. -To determine changes in anthropometric parameters and basal metabolic rate (BMR) in obese adolescents during and after 2 types of weight-reduction programs. Subjects -Zwenty-six adolescents (group I, Z-score of BMI = 4.72) followed a 9-month-weight reduction program including a moderate energy restriction and regular physical activities in a specialized institution. In addition, 39 adolescents E Z-score of BMI = 2.83) followed at home a 9-month-weight reduction program including medical and dietetic services. Body composition (by impedancemetry) and BMR (by indirect calorimetry) were assessed before the beginning (MO), 4 months after (M4) and at the end (M9) of the programs, then 4 months (M13) and 16 months (M25) after the end of the weight-reduction programs. Results .-Twenty-two adolescents in group I and 20 adolescents in group E complet At the beginning of the study, at M0, age, body weight (BW), fat-free mass (FFM) -and BMR of subjects of group I were higher (1.0 year, 36%, 30% and 23%, respectively, P <0.001 At M9, adolescents of group I showed significant reductions in BW and FM (-19 and -37%, respectively), than those of group E. Pubertal stage and percentage of fat mass (FM) , P <0.001), but not significant differences in FFM. In addition, BMR decreased significantly between M0 and M4, both in absolute value (-6.7%, P <0.001) and after adjustment for FFM ), and the difference was maintained until M9. Between M9 and M13, BW and Z-sc-ore of BMI were maintained in 12 adolescents, but increased (+ 9.7% and 14.8%, respectively, P <0.001) in 10 adolescents. However, BMR did not change significantly in all adolescents. Between M13 and M25, BW, FM, FFM and BMR increased significantly (+ 13%, + 34%, + 6% et + 5%, respectively, P <0.001) the 25 monthperiod, adolescents of group E showed significant increases in BW, FFM and BMR (+ 8%, + 14% and + 10%, respectively, P <0.001), and maintained their Z- score and FM. Conclusion. BMR during the weight-reduction program at the institution could contribute to body weight regain in the post-obese adolescents if they do not maintain the lifestyle of trying during the weight-reduction period. In other respects, the Z-score was stabilized in 51% of domiciled obese adolescents.