Childhood obesity : behind the doors of the epidemic

Childhood obesity is reaching alarming proportions and is currently one of the most important public health problems. It is associated with significant physical and psychosocial health consequences, both in the short and long term. In this thesis we looked below the tip of the childhood obesity iceberg, and dived into a few important issues encountered in daily clinical practice. Within this scope a range of studies was carried out. We investigated the health-related quality of life in children and adolescents at the start of hospital-based obesity treatment, studied the expression of adiponectin and leptin receptors on circulating immune cells in obese children pre- and post-lifestyle intervention compared to normal weight control children, and evaluated ambulatory blood pressure measurement patterns in a population of overweight and obese children and adolescents. Additionally, the effects of the multidisciplinary, multicomponent, family-based childhood obesity treatment programmes in Hospital Gelderse Vallei were investigated, specifically comparing overweight or obese (young) children and adolescents. Furthermore, a systematic review and meta-analysis was performed summarising the existing knowledge on programmes and initiatives aimed at long-term maintenance of a healthy or reduced weight in children and adolescents following initial treatment of overweight. Finally, several overarching theoretical, practical, and methodological issues derived from this thesis were discussed, followed by implications for clinical practice and directions for future research.