OBJECTIVE:To compare the 1-year outcome of obese children managed medically and dietetically in a group setting with those managed individually.PATIENTS AND METHODS:Two hundred and seventy-eight obese children [168 girls and 110 boys; body mass index (BMI) > + 2 SD] were followed by the Department of Pediatrics of the University Hospital of Angers between January 1996 and December 2002 (175 children in a group setting and 103 individually). The group program consisted of 3 monthly sessions of slide shows for groups of 10 children, followed by individual consultations once every 3 months alternating medical and dietetic concerns. The individual program consisted of successive medical and dietetic consultations on the same day once every 3 months.RESULTS:The children were 10.3 +/- 2.9 years old, and their BMI was 5.5 +/- 2.1 SD, with no difference between groups. The drop-out rate (children not returning after the 1st consultation) was 17%, with no difference between groups. The drop-out rate after 1 year was 65% in the group program and 41% in the individual program (p < 0.05). Of the children who were followed for 1 year, 88% of those treated in a group setting had stabilized or reduced their BMI, whereas 74% of the individually-treated children had done so (p < 0.05).CONCLUSION:Among obese children followed for 1 year, group treatment resulted in a greater percentage of stabilization or reduction in BMI than did individual treatment, although the drop-out rate was higher in the group setting. Psychological support and physical activity sessions adapted for obese children would help to maintain motivation in these children.

Objectifs. - Comparer le devenir a 1 an d'enfants obeses pris en charge en education therapeutique collective a celui d'enfants obeses pris en charge individuellement. Patients et methodes. - 278 enfants (168 filles et 110 garcons) obeses (indice de masse corporel (IMC) > + 2 DS) ont ete pris en charge dans le Departement de Pediatrie du CHU d'Angers entre janvier 1996 et decembre 2002 (103 enfants individuellement, et 175 enfants en l'education therapeutique collective). L'education therapeutique collective consistait en trois seances de diaporamas rassemblant 10 enfants a un mois d'intervalle, suivies de consultations individuelles alternees medicale et dietetique tous les trois mois. La prise en charge individuelle consistait en des consultations medicale et dietetique a la suite le meme jour tous les trois mois. Resultats. - Les enfants etaient âges de 10,3 ± 2,9 annees, et leur indice de masse corporelle (IMC) etait de 5,5 ± 2,1 DS, sans difference entre les deux groupes. Le taux d'abandon primaire (enfants ne revenant pas apres la premiere consultation) etait de 17 %, sans difference entre les groupes. Le taux d'abandon a un an etait de 65 % en prise en charge collective vs. 41 % en prise en charge individuelle (p < 0,05). Parmi les enfants suivis a 1 an, 88 % avaient stabilise ou abaisse leur IMC en prise en charge collective vs. 74 % en prise en charge individuelle (p < 0,05). Conclusion. - Parmi les enfants encore suivis apres 1 an, l'education therapeutique collective a permis de stabiliser ou d'abaisser l'IMC d'un pourcentage plus important d'enfants obeses que la prise en charge individuelle, au prix d'un taux d'abandon superieur. Une prise en charge psychologique et des seances d'activite physique adaptee aux sujets obeses pourraient permettre de mieux soutenir la motivation des enfants.