Tailored treatment in childhood obesity
Current obesity treatment fails for the majority of treatment seeking obese youths. Eating too much is the most important cause of childhood obesity, and a wide range of mechanisms may lead to overeating. Hence, unravelling appetite control is an increasing research field in obesity. Subjective as well as objective (hormonal) appetite control shows a huge variation between individuals which indicates a potential for differentiating obesity into phenotypes and tailor treatment according to their underlying characteristics. So far information on hormonal appetite control is mainly obtained from studies in adults and there is a call for studies in youths. The present study aims to test whether variation in appetite control patterns (phenotypes) at initial weight loss may serve as biomarkers for long term treatment effect in obese youths. We will also explore whether changes in hormonal appetite response is mediated by changes in gut microbiota. Study design: This is a longitudinal multi-center intervention study with repeated measures' The participants serve as their own controls' participants We will include 40 children / adolescents age 7-17 years with a BMI > isoBMI 30 and stable weight 2 months prior to inclusion' Setting and intervention: A two-week multidisciplinary lifestyle intervention camp will take place at three obesity rehabilitation centers: Røros, Muritunet and Evjeklinikken. In the one year follow-up the initial treatment will be boosted by regular meetings with the community care and two additional shorter stays in groups at the rehabilitation centers. Testing: Anthropometrics, Body composition, Cardiovascular fitness, Activity levels Habitual Food intake, Fasting and postprandial release of appetite-related hormones and Subjective feelingsof appetite, eating behavior questionnaires and stool samples will be obtained at baseline, two weeks and one year. The Project is in line with the original scedule in terms of the data collection that was finalized by the end of 2015. Regarding the hormone – and microbiota analyses we have some months delay due to sick leave in the study group. The analyses will take place in March 2016 and thus in time to reach the original scedule; to finalize the planned papers by the end of 2016. Clinical relevance Early stage identification of non-responders is imperative to lead youths past a long-time treatment that not has any effect on their obesity, and that will demotivate them for engaging in other treatments. If the biomarkers tested in the present study proves to be meaningful, in order to act as a descision support tool their discriminating abilities will need to be validated in subsequent larger populations. Furthermore, the biomarkers under study are expensive and resource demanding and will require translation into proxy methods suitable for clinical use. The present study constitutes an early step towards clinical research on development of novel treatments for groups of non-responders to obesity treatment.