Development and evaluation of a weight management service for children and adolescents living with obesity and severe obesity: Growing Healthy Kids in SWSLHD

Abstract

Children and adolescents living with obesity are at greater risk of immediate and long term poor physical and mental health, and significant psychosocial impacts. Evidence shows that lifestyle intervention is effective in reducing BMI in the short to medium term. The phrase lifestyle intervention, however, is poorly defined and there is limited specific guidance on how to apply the range the broad range of effective interventions to individuals in a real-world clinical setting. The establishment of the Growing Healthy Kids (GHK) paediatric weight management service in SWSLHD created an opportunity to explore these questions. This thesis presents, across eight chapters, the development, implementation, and evaluation of the GHK service, and the synthesis and testing of dietary interventions for the personalised management of obesity in children and adolescents. This thesis summarises the contemporary dietetic management of paediatric obesity and presents a systematic review and meta-analysis. This study demonstrated that as the degree of energy restriction increased, the interventions were incrementally more effective at reducing BMI. This thesis reports on the short-term impact of the GHK service on BMI, physical and psychological health, and wellbeing, building on the limited knowledge of the effectiveness of interventions among priority population groups. Overall, the GHK lifestyle intervention resulted in a significant improvement in BMI at 6-month follow-up. This thesis also presents a secondary data analysis, exploring the differential effectiveness of the predefined dietary intervention protocols on BMI providing an argument for defined energy target in all paediatric weight management interventions. This thesis concludes by discussing the key insights and future directions for clinical intervention, research practice and policy for the management of obesity among children and adolescents. and non-Aboriginal Australians will likely worsen.