Table 3

Components of the inpatient weight-loss program

Intervention component

Items

Description

Aims

Frequency/Dose


Structured physical activity (10 h/week)

Therapeutic sports

Different types of outdoor activities such as ascending stairs, road running and cross country runs etc.

Endurance training according to individual abilities

2x/week à 60 min


Swimming

Lane swimming ~1.000 m

Endurance training;

Learning/improving swimming technique

1x/week à 50 min

plus the 6 km walk to the pool (~3 km downhill, 3 km uphill)


Group sports

Different physical activities (e.g. ball games, dancing and gymnastics)

Focus on playing and having fun

1x/week à 45-90 min


Postural training

Strength training: gymnastics, dumbbells, stretch bands, etc.

Strength training to achieve or maintain good posture

1x/week à 45 min


Hiking

10-12 km hikes in the mountains

Endurance training with nature experience

1x/week à 3 h


Non structured physical activity (~6 h/week)

'Fun- Walk'

Walking to the town centre (~1 km downhill, 1 km uphill); Time for individual activities

Endurance training, having fun

1x/week à 2 h (in total)


Excursions

Various excursions and activities like playing miniature golf, sightseeing, table tennis tournaments, etc.

Having fun, group activities to improve social skills

Dimension of physical activity varies; within 4 weeks of intervention, it accounts for 6 h/week


Obesity patient training courses (16 sessions within 4 weeks)

Psychotherapy

• Developing rules for healthy eating behavior

• Rigid versus flexible dieting

Improving self-esteem and body perception, prevention of relapse.

5 session within 4 weeks à 45 min


• Recognition of signs of both hunger and satiety

• Learning to enjoy food as well as to cope with difficult situations


• Developing motivation for participating in regular physical activity


Individual sessions if the children suffer from psychosomatic, psycho-vegetative and/or psychological diseases

Treating individual psychological problems

1-3 individual sessions à 45 min/week


Nutritional lessons

Teaching children to choose the appropriate (amount of) food according to their personal needs

Enabling the children to prepare healthy food for themselves

5 sessions within 4 weeks à 45 min


Physical education

Improving knowledge on energy balance, effects and limitations of physical activity, measures of self-control and good posture

Increase knowledge of the effects of physical activity to support adherence to the regular physical activity recommendations

4 sessions within 4 weeks à 45 min


Medical education

Improving knowledge on medical background of overweight and obesity (normal/ideal weight, BMI, comorbidities etc.)

Increase knowledge of the medical consequences of overweight and obesity and promote a realistic goal setting

2 sessions within 4 weeks à 45 min


Social competence

Training sessions

• Training for conflict resolution, communication, ability to offer and receive criticism, body language, self-assurance, empathy etc.

• Role playing

• Concentration training

• Development of emotional-cognitive abilities

• Development of occupational skills

• Reflecting on and improving social behavior skills

1x/week à 45 min


Nutrition

Cooking

Cooking as a creative activity and a positive group experience

Transfer of theoretical knowledge into practice

1x/week, 2 h


Lessons for grocery shopping

• Learning how to read packaging labels correctly (e.g. sample sizes, nutritional information)

• Learning how to make educated nutritional decisions about potentially misleading products (e.g. 'organic')

Enabling the children to judge different food products correctly

1x/week, 90 min


Parents

Supportive training

Parents receive background information on obesity and advice about how to best support their child. In addition, they are requested to take their child to subsequent outpatient psychological treatment. They also receive special handouts about healthy living, including nutrition, physical activity, media consumption etc.

Improving parental support of the children after conclusion of the inpatient program

Two conversations with the physician (at the start and the end of intervention. In special cases, parents are contacted by telephone)


School

Theoretical lessons

German, English and Mathematics

Keeping the children current with the appropriate educational curriculum

Groups 3 and 4: 5x/week à 45 min

Groups 1 and 2: 6x/week à 45 min


Rank et al. BMC Pediatrics 2012 12:30   doi:10.1186/1471-2431-12-30

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