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ZusammenfassungHintergrund: FITOC (Freiburg Intervention Trial for Obese Children) ist ein interdisziplinäres Interventionsprogramm zur ambulanten Therapie der Adipositas im Kindes- und Jugendalter. Das seit 1987 existierende Programm beinhaltet eine Kombination aus organisiertem Sport, Ernährungsschulung und einer Verhaltenstherapie. Im Vergleich zu anderen Programmen erfolgt in FITOC eine Sportbetonung (3x/Woche eine spezielle Sportstunde). Das Programm ist seit August 2008 vom Medizinischen Dienst (MDS) zertifiziert und auf andere Regionen Deutschlands übertragbar.Methoden: Die Daten von 31 Gruppen mit 496 Kindern (267 Mädchen, 229 Jungen) mit einem mittleren Alter von 10,5 Jahre warden dargestellt. Körpergröße und Körpergewicht, LDL-Cholesterin (LDL-C) und körperliche Fitness wurden zu Therapiebeginn, nach 8,5 Monaten und nach 3,3 Jahren gemessen.Ergebnisse: Nach der achtmonatigen Intensivphase konnte bei beiden Geschlechtern sowohl der BMI als auch der BMI-SDS reduziert warden (pSchlussfolgerung: Die Ergebnisse zeigen, dass adipöse Kinder erfolgreich in dem ambulanten Programm behandelt werden können. Um den therapeutischen Erfolg zu erhalten, müssen die Kinder in Zusammenarbeit mit Vereinen in normale Sportgruppen integriert werden und Hilfe erhalten, einen aktiveren Lebensstil beizubehalten.

Obesity is considered to be epidemic worldwide. Stopping further progression interdisciplinary, outpatient intervention therapy programs for obese children have become increasingly important. FITOC (Freiburg Intervention Trial for Obese Children) consists of a combination of organized sports, behavioral therapy and nutritional advice. The effectiveness of the therapy is determined on the basis of anthropometrical and physical performance data. The purpose of this report is to give a differentiated view of the motor abilities of obese children and to describe changes in the course of the therapy program FITOC. Data were collected on n = 49 obese children (BMI > 97th percentile) aged 8 - 12 in a pretest at the beginning and posttest at the end of the intensive phase of the therapy. These data were compared with an age-matched German reference group. Besides the General Sports-Motor Test (Allgemeiner Sportmotorischer Test [AST]), the BMI-SDS values, the body fat mass (FM %) and the aerobic capacity (Watt/kg body weight) were recorded. In the pretest, the running exercise results and the aerobic capacity checked ranged significantly below the values of the reference group. The performance in the coordinative tests of the AST was differentiated. The medicine-ball toss was significantly above average of the reference group. In the posttest, the BMI-SDS values and the body fat mass (% FM) decreased (p < 0.001) and the aerobic capacity improved (p < 0.001). Performance in all motor abilities tests improved and the difference between the strength of the obese children and the strength of the reference group decreased. This study demonstrates that in obese children weight-bearing activities are below average but not all motor abilities.

The psychosocial situation of obese children at the beginning of the Freiburg Intervention Trial for Obese Children (FITOC) program influences the course and outcome of intervention therapy. At the beginning of FITOC, mothers of 30 children (12 ♂ age 10.5 ± 1.4, 18 ♀; 10.2 ± 1.3) rated the psychopathological symptoms using the Child Behavior Checklist (CBCL) and the quality of life of their children (Inventar zur Erfassung der Lebensqualität [ILK]). 46.6% of mothers rated their children to be disturbed (normal population group, 2% disturbed). There was no correlation between the body mass index of the child and the CBCL score. On the ILK, the obese children themselves selected “good” while the mother’s view of their childrens’ quality of life varied around “poor”. The stress on the mother increased with the degree of the child’s obesity and number of critical life events (p = 0.030). The CBCL and the ILK at the beginning of treatment serve as a good screening instrument for psychopathology and distress in children with obesity.