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Article |

Treatment of Obesity in Children

Albert J. Stunkard, MD; Robert I. Berkowitz, MD
JAMA. 1990;264(19):2550-2551. doi:10.1001/jama.1990.03450190082034.
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Two propositions about obesity are generally accepted: fat children grow into fat adults,1,2 and weight lost in treatment programs is promptly regained.3

It is against this background that the 10-year follow-up of treatment of obese children, reported by Epstein and colleagues4 in this issue of The Journal, must be considered. For this study showed that obese children treated for a very short period of time (eight weekly meetings followed by six monthly meetings) showed effects of treatment 10 years later, when they were significantly less obese than children in a comparison group.

How are we to explain these surprising results?

Three possible explanations seem unlikely. Differential attrition between treatment and control groups is always a possibility in long-term follow-up studies, and there was some attrition in this study. The attrition, however, was limited—only 14 of 75 children became unavailable for follow-up—and it was distributed about evenly among


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