First experiences of the Cigotica programme

INTRODUCTION The alarming spread of obesity epidemic in children and adolescents, as well as the lack of varified and efficient measures and programmes for obesity prevention, indicates the necessity to establish the Centre for the prevention, treatment and rehabilitation of obesity in children and adolescents and the Cigotica programme at the Special Hospital 'Zlatibor'. The advantage of the Cigotica programme is the multidisciplinary approach to treating obese children, which involves specific education, dietetic interventions with the decrease in the total amount of daily calorie intake, physical activity, clinical, educational and psychological support, change of behaviour and lifestyle. OBJECTIVE To present the effect of the multidisciplinary treatment of obese adolescents, participants in the Cigotica programme, and evaluate the weight of the examinees upon admittance and upon release. To establish the risk factors of nutritive obesity, obesity complications and biochemical risk factors. METHODOLOGY 580 adolescens were examined ( 291 girls and 289 boys) aged from 12 to 18, of the average age of 15.25 with diagnosed primary obesity, hospitalised at the Centre for prevention and treatment of obesity in children and adolescents at the Special hospital 'Zlatibor' in the period from July 27, 2008 to March 7,2010. The hospitalisation lasted 21 days. The obesity criterion was the body mass index (BMI) > +2 SD. The body mass, BMI, the percenrage of fat was obtained by means of the tanita scales for determining body composition by impendance method. Apart from clinical examination, the blood pressure was also measured. The levels of tryglicerides, total and both HDL and LDL cholesterols as well as glycemia were determined on the second and twenty-first days of fasting. RESULTS After the multidisciplinary treatment, the average body mass loss (p< 0.05 ) in all adolescents was 6.12 ± 2.91 kg, in boys 6.47 ±3.24 kg, and in girls - 5.76±2.41. During the 21 days of hospitalisation, the average BMI (p< 0.05) was reduced by -2.32 ± 0.31 in all examinees, in boys by -2.53 ± 48 and in girls by -2.08 ± 0.41 kg/ m2. BMI z-score is considerably lower in all examinees by (p<0,05) 0.29 ± 0.08, in girls it is lower by 0.28 ± 0.06 and in boys 0.32 ± 0.08. The percentage of fat is considerably reduced (p< 0,05) in all examinees -1.65 ± 0.23, in girls 1.82 ± 0.31 and in boys 1.48% ± 0.20. The waist circumference is reduced in all examinees by -7.98 ± 3.01, in girls -8.99 ± 4.1 and in boys -6.97 ± 2.8. The analyses of the weight of the examinees upon admittance and upon release, estimated on the bases of average BMI values, indicates that the multidisciplinary approach lasting for 21 days resulted in the considerable initial mass reduction, so that 19.14% examinees were of average weight, 50.68% were overweight and 30.18% were obese. CONCLUSION The effects of the Cigotica programme encourage and show that the multidisciplinary approach directed towards the reduction in energy intake, education, change of lifestyle and beliefs related to diet and physical activity lead to the considerable reduction in body mass, improvement in blood pressure and laboratory parameters, aerobic abilities and self-confidence in obese adolescents. A great interest of children, parents and doctors in the participation in the Cigotica programme indicates the rise of awareness about obesity risks and importance of health prevention at the adolescent age in our region. The participation in the Cigotica programme gives an adolescent an opportunity to choose between a healthy and unhealthy lifestyle. The efficiency of the Cigotica programme and the multidisciplinary treatment of obese adolescents will be evaluated in the current research that deals with the sustainability of the achieved results.