***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: OBJECTIVE To assess height growth over 10 years in children treated for obesity . DESIGN Longitudinal , prospect i ve follow-up of a series of r and omized , controlled weight control trials . SETTING Specialized pediatric weight control clinic . PARTICIPANTS One hundred fifty-eight 6- to 12-year-old obese children who were followed up for 10 years after treatment . INTERVENTIONS Family-based behavioral weight control . MEASUREMENTS /MAIN RESULTS At entry the height percentiles of the obese children were significantly higher ( 71.6 percentile ) than same-sex parent ( 52.0 percentile ) or midparent ( 51.5 percentile ) height ( an estimate of parental contribution to height ) . After an average growth of 22.7 cm , children were 2.2 cm taller than their same-sex parent and decreased to an average height percentile of 57.8 . Multiple regression analysis showed that child sex , age , baseline height and percent overweight , midparent height , and height change of the child from baseline to 5 years accounted for 94 % of the variance in growth . Child percent overweight change made no contribution to predicting height change . Comparison between children obese and nonobese at 10 years showed no differences in growth . CONCLUSIONS Moderate energy restriction with dietary guidance by overweight children did not negatively influence long-term growth CONTEXT The prevalence of overweight and obesity in children and adolescents is increasing rapidly . In this population , behavioral therapy alone has had limited success in providing meaningful , sustained weight reduction , and pharmacological treatment has not been extensively studied . OBJECTIVE To determine the efficacy and safety of orlistat in weight management of adolescents . DESIGN , SETTING , AND PATIENTS Multicenter , 54-week ( August 2000-October 2002 ) , r and omized , double-blind study of 539 obese adolescents ( aged 12 - 16 years ; body mass index [ BMI ] > or=2 units above the 95th percentile ) at 32 centers in the United States and Canada . INTERVENTIONS A 120-mg dose of orlistat ( n = 357 ) or placebo ( n = 182 ) 3 times daily for 1 year , plus a mildly hypocaloric diet ( 30 % fat calories ) , exercise , and behavioral therapy . MAIN OUTCOME MEASURES Change in BMI ; secondary measures included changes in waist and hip circumference , weight loss , lipid measurements , and glucose and insulin responses to oral glucose challenge . RESULTS There was a decrease in BMI in both treatment groups up to week 12 , thereafter stabilizing with orlistat but increasing beyond baseline with placebo . At the end of the study , BMI had decreased by 0.55 with orlistat but increased by 0.31 with placebo ( P = .001 ) . Compared with 15.7 % of the placebo group , 26.5 % of participants taking orlistat had a 5 % or higher decrease in BMI ( P = .005 ) ; 4.5 % and 13.3 % , respectively , had a 10 % or higher decrease in BMI ( P = .002 ) . At study end , weight had increased 0.53 kg with orlistat and 3.14 kg with placebo ( P<.001 ) . Dual-energy x-ray absorptiometry showed that this difference was explained by changes in fat mass . Waist circumference decreased in the orlistat group but increased in the placebo group ( -1.33 cm vs + 0.12 cm ; P<.05 ) . Generally mild to moderate gastrointestinal tract adverse events occurred in 9 % to 50 % of the orlistat group and in 1 % to 13 % of the placebo group . CONCLUSIONS In combination with diet , exercise , and behavioral modification , orlistat statistically significantly improved weight management in obese adolescents compared with placebo . The use of orlistat for 1 year in this adolescent population did not raise major safety issues although gastrointestinal adverse events were more common in the orlistat group BACKGROUND The prevalence of overweight and obesity in children and adolescents is increasing in both the United States and Mexico . OBJECTIVE The goal of this article was to assess the efficacy and safety of sibutramine in obese Mexican adolescents . METHODS This was a 6-month , r and omized , double-blind , placebo-controlled , prospect i ve clinical trial of sibutramine QD .  Male and female patients aged 14 to 18 years with sex-specific body mass index ( BMI ) for age and sex > 85th percentile were eligible . The primary end points for the trial were the baseline versus end point absolute values for body weight , BMI , and percentage of the initial BMI ( % BMI ) ; secondary end points were waist circumference and percentage of the initial waist circumference ( % waist ) . These were measured at days -15 , 0 , 30 , 60 , 90 , 120 , 150 , and 180 of the study . Quality of life was assessed at the study start and end using the 36-Item Short-Form Health Survey ( SF-36 ) question naire . Blood pressure and heart rate were assessed , and adverse events ( AEs ) were recorded . Both groups received individually tailored diet and exercise programs . RESULTS Forty-six patients ( age range , 14 - 18 years ) with a BMI > 95th percentile for age were included ( sibutramine group , n = 23 [ 14 females , 9 males ] ; placebo group , n = 23 [ 12 females , 11 males ] ) . Twenty-one patients in the sibutramine group and 19 patients in the placebo group completed the 6-month trial . Using the intent-to-treat data , weight ( mean [ SD ] ) in the sibutramine group changed from 92.5 ( 14.6 ) kg to 85.7 ( 14.4 ) kg , for a net weight loss of 7.3 kg ( 95 % CI 4.6 - 9.9 ) , a waist circumference loss of 8.0 cm ( 95 % CI , 4.7 - 11.3 ) , and a % BMI loss of 9.2 % ( 95 % CI , 6.9 - 11.6 ) . In the placebo group , weight changed from 98.9 ( 22.7 ) kg to 94.6 ( 22.5 ) kg , a weight loss of 4.3 kg ( 95 % CI , 1.7 - 6.9 ) , a waist circumference loss of 3.8 cm ( 95 % CI , 0.7 - 7.0 ) , and a % BMI loss of 5.2 % ( 95 % CI , 2.4 - 7.9 ) ( P < 0.05 for all intragroup comparisons ; P > 0.05 for the intergroup comparisons ) . Mean ( SD ) scores on the SF-36 scale in the sibutramine group changed from 78.0 ( 13.3 ) at baseline to 84.8 ( 7.4 ) at study end ( P < 0.05 ) ; the respective values in the placebo group were 82.8 ( 10.3 ) and 87.3 ( 7.6 ) ( P < 0.05 ) . At base-line , systolic blood pressure ( SBP ) was 116.7 ( 5.9 ) mm Hg in the sibutramine group and 118.3 ( 7.6 ) mm Hg in the placebo group ; at end point , the respective SBPs were 112.4 ( 9.6 ) mm Hg and 112.6 ( 6.5 ) mm Hg . At baseline , diastolic blood pressure ( DBP ) was 78.9 ( 4.5 ) mm Hg in the sibutramine group and 79.5 ( 5.2 ) mm Hg in the placebo group ; at end point , the respective DBPs were 73.5 ( 6.3 ) mm Hg and 76.6 ( 6.2 ) mm Hg . At baseline , heart rate was 76.3 ( 6.4 ) beats/min in the sibutramine group and 81.1 ( 9.5 ) beats/min in the placebo group ; at end point , the respective findings were 79.8 ( 8.8 ) beats/min and 77.6 ( 8.6 ) beats/min ( P > 0.05 for all preceding intergroup comparisons ) . One patient in the sibutramine group had increased blood pressure ( at month 3 ) and 3 had increased heart rate ( at months 1 , 2 , and 4 ) ; 2 patients receiving placebo had increased blood pressure ( month 3 ) and 2 had increased heart rate ( at months 1 and 3 ) . These changes disappeared in 1 week and did not require treatment or trial suspension . Additionally , in the sibutramine group , 3 patients experienced 4 mild AEs : headache , dry mouth , headache with nausea , and headache with weakness and paleness ( P > 0.05 ) . In the placebo group , 3 patients experienced 4 mild AEs : 2 cases of headache , as well as 1 case of headache with somnolence and 1 case of headache with dry mouth ( P > 0.05 ) . CONCLUSION Sibutramine 10 mg QD in addition to diet and exercise was effective and generally well tolerated in this population of obese Mexican adolescents OBJECTIVE To determine whether regular aerobic exercise improves symptoms of sleep-disordered breathing in overweight children , as has been shown in adults . RESEARCH METHODS AND PROCEDURES Healthy but overweight ( BMI > or = 85th percentile ) 7- to 11-year-old children were recruited from public schools for a r and omized controlled trial of exercise effects on diabetes risk . One hundred children ( 53 % black , 41 % male ) were r and omly assigned to a control group ( n = 27 ) , a low-dose exercise group ( n = 36 ) , or a high-dose exercise group ( n = 37 ) . Exercise groups underwent a 13 + /- 1.5 week after-school program that provided 20 or 40 minutes per day of aerobic exercise ( average heart rate = 164 beats per minute ) . Group changes were compared on BMI z-score and four Pediatric Sleep Question naire scales : Snoring , Sleepiness , Behavior , and a summary scale , Sleep-Related Breathing Disorders . Analyses were adjusted for age . RESULTS Both the high-dose and low-dose exercise groups improved more than the control group on the Snoring scale . The high-dose exercise group improved more than the low-dose exercise and control groups on the summary scale . No group differences were found for changes on Sleepiness , Behavior , or BMI z-score . At baseline , 25 % screened positive for sleep-disordered breathing ; half improved to a negative screen after intervention . DISCUSSION Regular vigorous exercise can improve snoring , a symptom of sleep-disordered breathing , in overweight children . Aerobic exercise programs may be valuable for prevention and treatment of sleep-disordered breathing in overweight children Aims : To evaluate effects of a low energy diet , with or without strength training , on blood lipid profile in obese children . Methods : Eighty two obese children were enrolled into a six week dietary programme , and were r and omly allocated to a training group or a non-training group . The training group underwent regular exercise sessions with emphasis on strength training . Results : Height increased significantly , with a non-significant reduction in body mass index . Fat free mass increased significantly in the training group . Serum total cholesterol was significantly reduced in both groups . The LDL : HDL ratio significantly decreased in the training group . Conclusion : Results support the potentially beneficial effects of both diet and physical training . Further and longer term evaluation of such programmes is required OBJECTIVE To evaluate the efficacy of orlistat to enhance weight loss in obese adolescents . METHODS The study was a 6-month r and omized , double-blind , placebo-controlled trial to compare the effects of orlistat ( 120 mg orally 3 times a day ) and placebo on reduction of body mass index ( BMI ) .  Forty adolescents between 14 and 18 years of age with a mean BMI of 40 kg/m2 entered the protocol between December 2002 and February 2003 . Study subjects stayed overnight in the General Clinical Research Center , during which dietary records were review ed and lifestyle recommendations were given . The study participants received either orlistat ( 120 mg orally 3 times a day ) or placebo and were assessed monthly for 6 months . At 0 , 3 , and 6 months , fasting laboratory tests were performed . The primary end point was the change in BMI from baseline to 6 months . Secondary outcomes included changes in weight , lean body mass , and results of blood chemistry studies . RESULTS No statistically significant difference was noted between the 2 study groups for decrease in BMI from baseline to 6 months ( P = 0.39 ) . The decrease in BMI within the orlistat group ( -1.3 + /- 1.6 kg/m2 ; P = 0.04 ) and within the placebo group ( -0.8 + /- 3.0 kg/m2 ; P = 0.02 ) , however , was statistically significant . Laboratory measurements did not differ between the 2 groups . In comparison with the placebo group , the orlistat group had increased adverse events , primarily gastrointestinal symptoms and findings . CONCLUSION In this study of obese adolescents , orlistat did not significantly reduce BMI in comparison with placebo at 6 months Background . Obesity has become the 
    Output:
    
More limited evidence suggests that these improvements can be maintained over the 12 months after the end of treatments and that there are few harms with behavioral interventions .
Potential adverse effects were greater than for behavioral interventions alone and varied in severity .
Despite important gaps , available research supports at least short-term benefits of comprehensive medium- to high-intensity behavioral interventions in obese children and adolescents