***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Background We developed a Dutch outpatient multidisciplinary group treatment ( Go4it ) for obese adolescents , including cognitive behavioural therapy and education on healthy dietary and physical activity behaviour . This study examined the effect of Go4it on Health Related Quality of Life ( HRQoL ) . Methods At our outpatient paediatric obesity clinic , obese adolescents ( n = 122 , 11–18 years ) were r and omly assigned to 1 ) Go4it , 7 sessions with an interval of 2 weeks or 2 ) current regular care consisting of referral to a dietician in the home care setting ( controls ) . Linear mixed model analysis was performed to evaluate the intervention effects on HRQoL at 6 and 18-month follow-ups . HRQoL indicators included the Child Health Question naire , the Paediatric Quality of Life Inventory ™ Version 4.0 ( PedsQL ™ 4.0 ) , and the Body Esteem Scale ( BES ) . Results In total , 95 adolescents ( Go4it 57 , controls 38 ) were included in the current analysis with a mean age of 14.5 ± 1.7 and mean BMI -SDS of 2.9 ± 0.5 . At baseline , all participants experienced lower levels of physical and psychosocial well-being compared to a normal weight reference group . At the 18 month follow-up , we found small but beneficial intervention effects on all subscales of the PedsQL ™ 4.0 and BES question naires . Two subscales improved significantly ; i.e. , physical health ( between group difference 5.4 ; 95%CI : 0.3 ; 10.6 ) , and school functioning ( between group difference 7.4 ; 95%CI : 1.6 ; 13.2 ) . Conclusion Obese adolescents  experienced lower HRQoL than their healthy peers . The Go4it intervention had small beneficial effects on HRQoL compared to the current regular care practice s for obese adolescents . Trial registration Netherl and s Trial Register : IS RCT N27626398 , METC number : 05.134 ( WMO , monocenter ) OBJECTIVE To verify the effects of an intervention program including physical exercise and recreational activities , as well as nutritional counseling , on the health-related quality of life of obese children . METHODS This was a controlled clinical trial . The initial study population included children aged eight to 11 years with a body mass index ( BMI ) > 97th percentile for age and gender , according to the criteria of the World Health Organization , totaling 44 children matched by gender and age , as case ( n = 22 ) and control groups ( n = 22 ) .  BMI and self-reported health-related quality of life by Pediatric Quality of Life Inventory were measured before and after 12 weeks of intervention ( three times weekly ) . The control group did not participate in the intervention . RESULTS Thirty-two children completed the study ( 16 in each group ) . The case group showed significant reduction in BMI ( p = 0.001 ) and improved quality of life in the physical ( p = 0.001 ) , emotional ( p = 0.014 ) , social ( p = 0.004 ) , and psychosocial ( p = 0.002 ) domains , as well as in overall quality of life ( p = 0.001 ) , which was not observed in the control group . CONCLUSION The program was effective in improving the health and quality of life of obese children BACKGROUND AND OBJECTIVE : Most clinic-based weight control treatments for youth have been design ed for preadolescent children by using family-based care . However , as adolescents become more autonomous and less motivated by parental influence , this strategy may be less appropriate . This study evaluated a primary care – based , multicomponent lifestyle intervention specifically tailored for overweight adolescent females . METHODS : Adolescent girls ( N = 208 ) 12 to 17 years of age ( mean ± SD : 14.1 ± 1.4 years ) , with a mean ± SD BMI percentile of 97.09 ± 2.27 , were assigned r and omly to the intervention or usual care control group . The gender and developmentally tailored intervention included a focus on adoptable healthy lifestyle behaviors and was reinforced by ongoing feedback from the teen ’s primary care physician . Of those r and omized , 195 ( 94 % ) completed the 6-month posttreatment assessment , and 173 ( 83 % ) completed the 12-month follow-up . The primary outcome was reduction in BMI z score . RESULTS : The decrease in BMI z score over time was significantly greater for intervention participants compared with usual care participants ( −0.15 in BMI z score among intervention participants compared with −0.08 among usual care participants ; P = .012 ) . The 2 groups did not differ in secondary metabolic or psychosocial outcomes . Compared with usual care , intervention participants reported less reduction in frequency of family meals and less fast-food intake . CONCLUSIONS : A 5-month , medium-intensity , primary care – based , multicomponent behavioral intervention was associated with significant and sustained decreases in BMI z scores  among obese adolescent girls compared with those receiving usual care Background The negative impact of overweight ( including obesity ) and related treatment on children 's and adolescents '  health-related quality of life ( HRQoL ) has been shown in few specific sample s thus far . We examined HRQoL and emotional well-being in overweight children from an outpatient treatment sample as well as changes of these parameters during treatment . Methods In a cross-sectional design , self-reported HRQoL of 125 overweight ( including obese ) children who contacted a treatment facility , but had not yet receive treatment , were compared to 172 children from r and omly selected schools using independent two- sample t-tests . Additionally , in a longitudinal design , the overweight children were retested by administering the same question naire at the end of the intervention ( after one year ) . It included measures such as the  body mass index ( BMI ) , the general health item ( GHI ) , the KINDLR , and the Child Dynamic Health Assessment Scale ( ChildDynHA ) . Comparisons were based on dependent t-tests and the Wilcoxon signed-rank test . Results Overweight children showed statistically significant impairment in the GHI ( Cohen 's d = 0.59 ) and emotional well-being ( ChildDynha ) ( d = 0.33 ) compared to the school children . With respect to HRQoL , the friends dimension of the KINDLR was significantly impaired in the overweight group ( d = 0.33 ) . However , no impairment was found for the total HRQoL score or other KINDLR subdimensions . Regarding the longitudinal part of our study , most of the children improved their BMI , but the majority ( 87.5 % ) remained overweight . Nevertheless , the participants ' perceived health , emotional well-being , and generic as well as disease-specific HRQoL improved during intervention . Conclusion The findings emphasize the importance of patient-reported outcomes such as HRQoL. Even though overweight and obesity might accompany most of the children throughout their lifetime , the impairment associated with this chronic condition can be considerably reduced . Opportunities of health promotion in overweight/obese children and adolescents are discussed BACKGROUND Few successful treatment modalities exist to address childhood obesity . Given Latinos ' strong identity with family , a family-focused intervention may be able to control Latino childhood obesity . PURPOSE To assess the feasibility and effectiveness of a family-centered , primary care-based approach to control childhood obesity through lifestyle choices . DESIGN R and omized waitlist controlled trial in which control participants received the intervention 6 months after the intervention group . SETTING / PARTICIPANTS Forty-one Latino children with BMI > 85 % , aged 9 - 12 years , and their caregivers were recruited from an urban community health center located in a predominantly low-income community . INTERVENTION Children and their caregivers received 6 weeks of interactive group classes followed by 6 months of culturally sensitive monthly in-person or phone coaching to empower families to incorporate learned lifestyles and to address both family and social barriers to making changes . MAIN OUTCOMES MEASURES Caregiver report on child and child self-reported health-related quality of life ( HRQoL ) ; metabolic markers of obesity ; BMI ; and accelerometer-based physical activity were measured July 2010-November 2011 and compared with post-intervention assessment s conducted at 6 months and as a function of condition assignment . Data were analyzed in 2012 . RESULTS Average attendance rate to each group class was 79 % . Socio-environmental and family factors , along with knowledge , were cited as barriers to changing lifestyles to control obesity . Caregiver proxy and child self-reported HRQoL improved for both groups with a larger but not nonsignificant difference among intervention vs control group children ( p=0.33 ) . No differences were found between intervention and control children for metabolic markers of obesity , BMI , or physical activity .  CONCLUSIONS Latino families are willing to participate in group classes and health coaching to control childhood obesity . It may be necessary for primary care to partner with community initiatives to address childhood obesity in a more intense manner . TRIAL REGISTRATION This study is registered at Clinical trials.partners.org 2009P001721 Background : The best outcomes for treating childhood obesity have come from comprehensive family-based programmes . However there are questions over their generalizability . Objective : To examine the acceptability and effectiveness of ‘ family-based behavioural treatment ’ ( FBBT ) for childhood obesity in an ethnically and socially diverse sample of families in a UK National Health Service ( NHS ) setting . Methods : In this parallel group , r and omized controlled trial , 72 obese children were r and omized to  FBBT  or a waiting-list control . Primary outcomes were body mass index ( BMI ) and BMI s.d . scores ( SDSs ) . Secondary outcomes were weight , weight SDSs , height , height SDSs , waist , waist SDSs , FM index , FFM index , blood pressure ( BP ) and psychosocial measures . The outcomes were assessed at baseline and after treatment , with analyses of 6-month data performed on an intent-to-treat ( ITT ) basis . Follow-up anthropometric data were collected at 12 months for the treatment group . Results : ITT analyses included all children with baseline data ( n=60 ) . There were significant BMI SDS changes ( P<0.01 ) for the treatment and control groups of −0.11 ( 0.16 ) and −0.10 ( 1.6 ) . The treatment group showed a significant reduction in systolic BP ( −0.24 ( 0.7 ) , P<0.05 ) and improvements in quality of life and eating attitudes ( P<0.05 ) , with no significant changes for the control group . However the between-group treatment effects for BMI , body composition , BP and psychosocial outcomes were not significant . There was no overall change in BMI or BMI SDSs from 0–12 months for the treatment group . No adverse effects were reported . Conclusions : Both treatment and control groups experienced significant reductions in the level of overweight , but with no significant difference between them . There were no significant group differences for any of the secondary outcomes . This trial was registered at http://www.controlled-trials.com/ under IS RCT N 51382628 OBJECTIVES To investigate changes in health-related quality of life ( HRQOL ) , body mass index ( BMI ) , physical activity , and sedentary behavior at 24 months after an inpatient weight-loss program and to examine correlations between changes in HRQOL and BMI or physical activity . STUDY DESIGN This prospect i ve study included 707 overweight and obese individuals ( mean age , 14 ± 2 years ; 57 % girls ) participating in a 4- to 6-week inpatient weight-loss program , 381 of whom completed a 24-month follow-up .  HRQOL , physical activity , sedentary behavior , and BMI  were assessed at baseline , at discharge , and at 6 , 12 , and 24 months after starting therapy . Longitudinal analyses were conducted using repeated- measures mixed models , adjusted for age , sex , and baseline outcome and accounting for attrition over time . RESULTS All variables improved over treatment and 6-month follow-up ( P < .05 ) . At 24 months , overall HRQOL indicated improvements relative to baseline ( 3 points on a scale of 0 - 100 ; 95 % CI , 1.68 - 4.47 ; P < .001 ) . Of the 6 HRQOL domains , the greatest improvement was observed for self-esteem ( 11 points ; 95 % CI , 8.40 - 13.14 ; P < .001 ) . BMI was 0.5 kg/m(2 ) lower than at baseline ( 95 % CI , -0.92 to -0.02 ; P = .04 ) . Long-term changes in physical activity explained 30 % of the variation in overall HRQOL ( P = .01 ) , and change in BMI was not associated with a change in HRQOL . CONCLUSIONS This inpatient weight-loss program was associated with positive changes in HRQOL over the long term , with particular improvements in self-esteem . The results indicate the potential role of physical activity in improving HRQOL without a substantial change in body composition Purpose To evaluate the effect of multidisciplinary treatment on obesity and health-related quality of life ( HRQOL ) 
    Output:
    
Conclusion There is insufficient evidence that MI programs , aim ed to reduce weight in overweight and obese children , improve