GO4IT The effectiveness of a group intervention programme on the lifestyle of adolescents with obesity.

The prevalence of overweight and obesity in children and adolescents is rapidly increasing in the Netherlands. The current epidemic of overweight and obesity is caused largely by an environment that promotes excessive food intake and discourages physical activity. As a result of the increase in obesity among children, the first children and adolescents with type 2 diabetes mellitus were encountered during the last Dutch national surveillance system of diabetes mellitus in children. Type 2 diabetes mellitus leads to complications such as hypertension, cardiovascular problems, retinopathy, diminished kidney function and disability as a result of neuropathy and finally early death. Among children (aged 8-12 years) it has been shown that an intensive intervention programme, aimed at a healthy lifestyle, can lead to weight reduction in the long term. An effective treatment for adolescents (age 12-18 years) with overweight and obesity is not available at this moment. For this reason, the departments of paediatric endocrinology, nutrition and dietetics, medical psychology and the EMGO Institute, at the VU University Medical Center in Amsterdam, developed an intervention programme (GO4IT) for obese adolescents. The aim of GO4IT is to improve dietary, physical activity and sedentary behaviour of obese adolescents in order to prevent the development of Diabetes Mellitus type 2 by normalization of the glucose-intolerance and insulin resistance. The aim of this project is to evaluate the effectiveness of GO4IT in a randomised, controlled trial with an economic evaluation alongside. GO4IT is a new multidisciplinary group treatment that will be compared to usual care, i.e. individual consultation by a dietician. During 7 sessions and 4 booster sessions the adolescents will be educated on diet and physical activity, energy balance and how to improve their lifestyle regarding to a healthy weight and maintenance of the energy balance. Besides these sessions also two sessions will be organised for their parents. Body composition, glucose tolerance, insulin resistance, dietary, physical activity and sedentary behaviour will be assessed at baseline as well as after 6 and 18 months intervention. When GO4IT appears to be effective, the program can be implemented nation-wide through the different health care institutions.