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Am Fam Physician. 1999;60(8):2396-2398

America's youth have demonstrated a trend toward unhealthy lifestyles. They are becoming fatter, less active and less physically fit. More than one fourth of children in the United States are considered obese by clinical standards. Physical exercise has been shown to help in decreasing body weight, yet obese children tend to be less motivated to engage in physical activity. To assist obese children in weight reduction, motivation needs to be an integral part of the weight-management program. Sothern and associates studied the role of motivational methods and progressive exercise in increasing physical activity in children enrolled in a weight-management program.

Seventy-three children who were obese by clinical standards were enrolled in the study. The first three levels of physical activity were based on the severity of each child's obesity and then there was a maintenance phase once the children reached their goal weight. Anthropometric measurements were performed initially, at week 10 and one year. The program consisted of a protein-sparing modified fast diet, behavioral modification and a progressive exercise program with motivation techniques. Parents and family members were also encouraged to be involved in the program.

Sixty-nine of the children completed 30 weeks of the program, and 48 completed one year. Initial body weights were significantly reduced at 10 weeks. The mean percentage of ideal body weight was reduced at 10 weeks and maintained at one year. The percentage of body fat and mean body mass index were also reduced at 10 weeks, and that reduction was maintained for one year. The children increased their physical activity levels and maintained that increase for one year.

The authors conclude that a structured program that encourages and motivates obese children to exercise can help reduce weight and body fat in these persons. Such a program can also improve physical activity levels.

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