Adiposity follow-up care by phone and computer

A new computer-based phone counseling program offers individual adiposity follow-up care for adolescents.

The numbers are alarming. Every sixth to seventh child in Germany is overweight, every fifteenth even is obese. The media is full of bad news about the body weight of following generations. Unfortunately those are facts. And another fact is: the earlier overweight is becoming a problem, the harder it will be later to get rid of it. This poses the biggest challenge. In many places the obese youths and children are offered outpatient and stationary therapies that get rid of the extra pounds quickly. But the initial success is rarely permanent. In too many cases the yo-yo effect kicks in after a couple of weeks and the patients gain weight again, in some cases even more than before their therapy.

Therefore it is very important to accompany and counsel the young patients after their weight reduction. But follow-up care programs in the field of adiposity often only exist for adults and are very rare for children and adolescents. "It is especially hard for teenagers to find appropriate counseling programs. Adressing those patients through their parents is not very promising. They have to be adressed directly," knows nutritionist Jana Markert of the Integrated Research and Treatment Center (IFB) AdiposityDiseases in Leipzig. "In adition to that most of the follow-up care programs can only be found on location and are bound to fixed groups, thus forcing the patient to continiously return to the clinic."

With support of the research group "Preventive Medicine" of Dr. Susann Blüher, Markert works on a follow-up care program especially for adolescents which uses the phone for the counseling of the young obesity patients and the internet for their contact among each in form of a private forum. The program adresses young patients of different hospitals in Leipzig who went through a weight loss treatment. The adolescents can decide by themselves when and how they want to communicate with other patients and experts and what they want to talk about. Thus it is also possible to reach the patients effectively through all media channels. "The teen gets rid of additional tours and can be cared for individually," explains the young scientist Markert the advantages of counseling by phone.

For the follow-up care on the phone the research team recruited a group of experts "that have been especially trained for this study", Dr. Blüher introduces the experts on the other side of the line. They counsel the teens during the program during a total of nine phone calls of 30 minutes each. The primary goal is to also reach the affected people after finishing their therapy in every day life. Since this is when the young patients show whether they are able to implement the trained strategies. And according to Jana Markert that requires mental support first and foremost: "In our follow-up care program the patient e.g. can make his/her own suggestions for their diet and the necessary exercise. The phone counselor gives them tips for carrying those out and supports their ideas. It is primarily about the psychological well-being of the young patient. If they are able to maintain the behavior they learned during therapy to some degree, there is a good chance to stabilize the achieved weight loss."

Therefore it is necessary to also offer a comprehensive program for the follow-up care. Markert knows: "It is especially hard for obese teenagers to find their own healthy lifestyle in our obesogenic environment. Therefore an individual support should be the core of every follow-up care. Our program is supposed to encourage young patients to become aware of their own strength and possibilities. They can actively and especially independently do something for their permanent weight loss." How effective the phone counseling really is and in how far such new forms of follow-up care are even employable is being investigated by Jana Markert in a paralell study:"This ensures the continuous evaluation of the follow-up care program and enables us to correct mistakes quicker," she emphasizes, "since we want to permanently establish computer-based phone counseling programs in the field of adiposity."                                                                                                                   

Annekathrin Härter

Keywords: obesity treatment, children & youths