{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T20:20:56Z","timestamp":1790194856811,"version":"4.1.0"},"reference-count":21,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2012,9,6]],"date-time":"2012-09-06T00:00:00Z","timestamp":1346889600000},"content-version":"vor","delay-in-days":1193,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Obesity"],"published-print":{"date-parts":[[2009,6]]},"abstract":"<jats:p>\n                    Although randomized controlled trials demonstrated the long\u2010term efficacy of lifestyle interventions in overweight children, the effects of these interventions in clinical practice under real\u2010life conditions are largely unknown. One hundred twenty\u2010nine centers specialized in outpatient pediatric obesity care participated in this quality assessment. All patients presenting before the year 2006 for lifestyle intervention of at least 6 months duration in these institutions were analyzed in a 2\u2010year follow\u2010up. A total of 21,784 (45% male) overweight children and adolescents aged 2\u201320 years (mean BMI 30.4 kg\/m\n                    <jats:sup>2<\/jats:sup>\n                    , mean SDS\u2010BMI 2.51, mean age 12.6 years) were included in the analysis. Based on an intention\u2010to\u2010treat analysis with variables set back to baseline in lost of follow\u2010up, 22% of the children reduced their SDS\u2010BMI after 6 months, 15% after 12 months, and 7% after 24 months, but only in 24, 17, and 8% of children, respectively, complete data were available. In the five treatment centers with the best outcome (518 patients), 83% of the children reduced their overweight after 6 months, 67% after 12 months, and 51% after 24 months. Under real\u2010life conditions, most treatment centers cannot prove the long\u2010term efficacy of their interventions due to high drop\u2010out rate or lack of documentation. Conversely, some institutions achieved a reduction of overweight in nearly the half of their patients 24 months after baseline demonstrating the great heterogeneity in outcome. To improve the effectiveness of lifestyle interventions in real\u2010life studying, the process and structure quality as well as their long\u2010term results is urgently needed.\n                  <\/jats:p>","DOI":"10.1038\/oby.2009.17","type":"journal-article","created":{"date-parts":[[2009,2,27]],"date-time":"2009-02-27T05:34:55Z","timestamp":1235712895000},"page":"1196-1199","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":114,"title":["Two\u2010year Follow\u2010up in 21,784 Overweight Children and Adolescents With Lifestyle Intervention"],"prefix":"10.1002","volume":"17","author":[{"given":"Thomas","family":"Reinehr","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kurt","family":"Widhalm","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dagmar","family":"l'Allemand","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susanna","family":"Wiegand","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Wabitsch","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reinhard W.","family":"Holl","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"The APV\u2010Wiss Study Group and German Competence Net 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