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'BOB'

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  1. 'BOB' A pilot study of the acceptability and efficacy of intra-gastric balloons (IGB) in the treatment of severe adolescent obesity Lindsey Reece Senior Researcher l.reece@shu.ac.uk CLAHRC for South Yorkshire

  2. Childhood / Adolescent Obesity Scale of the issue... • 30-45 million children (5-17 yrs) obese worldwide. • Child Health Survey England 2010, 19% obese adolescents. • Negative implications on future health. • A small number are very severely obese. • More immediate consequences. • Diet, physical activity, medication (NICE 2006) little help in a proportion of these young people.

  3. Childhood Obesity Measurement • Expressed as a BMI SDS . • Take into account variation with age. • Plot on centile chart. • Severe obesity >99.6thcentile. • Very severe obesity > 3.5 SDS equivalent to Class lllobesity at 18 years.

  4. Rationale for IGB • Sited endoscopically - stays in for 6 months. • Work by inducing a feeling of satiety. Why BOB ? http://www.prweb.com/releases/2009/10/prweb3067964.htm

  5. Rationale for IGB • Less invasive than bariatric surgery. • Average weight loss 17.8 kg. • Change in BMI 4-9 kg/m2 • Reversible, cheaper, culturally acceptable. • Safer, fewer complications. • Untested in adolescents. Why BOB for this population

  6. Study Aims What we hope to find out... • A pilot study. • Intra-gastric balloons (IGB) supported by lifestyle management programme. • Weight loss and change in BMI at 6 months. • Sustained at 18 months. • Morbidly obese adolescents(adult BMI>40 kg/m2).

  7. Study Aims cont... Outcome measures • Biomedical outcomes. • Changes in total fat mass, bone mineral content, bone density. • Changes in psychosocial measures. • Changes physical fitness and physical activity. • Changes in school attendance.

  8. Method • 12 adolescents, BMI >3.5 SD (Severe Obesity). • Aged 13-16 years, average weight 130 kg. • Completed majority of growth. • Recruitment- Existing clinic population, peripatetic clinics, existing weight management programmes, advertisements. • Previous participation in weight/behaviour management programme essential. Who is this for ?

  9. Behavioural Management Program What's involved ? Maintenance Meet and Greet Balloon Removed Balloon Inserted Life with BOB Life after BOB Life Ahead Follow ups (12, 18, 24 mth) Life before BOB Weekly support 8 weeks Weekly support 4 weeks Weekly support, 6 months

  10. Summary • Innovative pilot looking at effectiveness of BOB (IGB) in kick starting weight loss in morbidly obese adolescents. • Robust theoretical underpinning. • Structured, evidence based, behavioural lifestyle support program. Recruiting now..... If you know anyone who meets the criteria and who is interested please take a leaflet and get in touch ....

  11. Thank you Lindsey Reece 0114 225 4355 l.reece@shu.ac.uk