1. 'BOB'
A pilot study of the acceptability and efficacy of intra-gastric balloons (IGB) in the treatment of severe adolescent obesity
Lindsey Reece
Senior Researcher
CLAHRC for South Yorkshire

2. Childhood / Adolescent Obesity
Scale of the issue...
30-45 million children (5-17 yrs) obese worldwide.
Child Health Survey England 2010, 19% obese adolescents.
Negative implications on future health.
A small number are very severely obese.
More immediate consequences.
Diet, physical activity, medication (NICE 2006) little help in a proportion of these young people.

3. Childhood Obesity Measurement Expressed as a BMI SDS .
Take into account variation with age.
Plot on centile chart.
Severe obesity >99.6th centile.
Very severe obesity > 3.5 SDS equivalent to Class lll obesity at 18 years.

4. Rationale for IGB Why BOB ?
Sited endoscopically - stays in for 6 months.
Work by inducing a feeling of satiety.

5. Rationale for IGB Why BOB for this population
Less invasive than bariatric surgery.
Average weight loss 17.8 kg.
Change in BMI 4-9 kg/m2
Reversible, cheaper, culturally acceptable.
Safer, fewer complications.
Untested in adolescents.

6. Study Aims What we hope to find out... A pilot study.
Intra-gastric balloons (IGB) supported by lifestyle management programme.
Weight loss and change in BMI at 6 months.
Sustained at 18 months.
Morbidly obese adolescents(adult BMI>40 kg/m2).

7. Study Aims cont... Outcome measures Biomedical outcomes.
Changes in total fat mass, bone mineral content, bone density.
Changes in psychosocial measures.
Changes physical fitness and physical activity.
Changes in school attendance.

8. Method
Who is this for ?
12 adolescents, BMI >3.5 SD (Severe Obesity).
Aged years, average weight 130 kg.
Completed majority of growth.
Recruitment- Existing clinic population, peripatetic clinics, existing weight management programmes, advertisements.
Previous participation in weight/behaviour management programme essential.

10. Behavioural Management Program
What's involved ?
Maintenance
Meet and Greet
Balloon Removed
Balloon Inserted
Life with BOB
Life after BOB
Life Ahead
Life before BOB
Follow ups (12, 18, 24 mth)
Weekly support
8 weeks
Weekly support
4 weeks
Weekly support, 6 months

11. Summary
Innovative pilot looking at effectiveness of BOB (IGB) in kick starting weight loss in morbidly obese adolescents.
Robust theoretical underpinning.
Structured, evidence based, behavioural lifestyle support program.
Recruiting now.....
If you know anyone who meets the criteria and who is interested please take a leaflet and get in touch ....

12. Thank you
Lindsey Reece