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Table 2 Measures for treatment of obesity from birth to the age at diagnosis of leptin receptor deficiency in the two patients

From: Diagnostic and therapeutic odyssey of two patients with compound heterozygous leptin receptor deficiency

 

Age, year (y) month (m)

Measures for treatment of obesity

Impact on weight

Patient 1

Ongoing

Restrictive food intake and motivation for physical activity

None

0 y 9 m

9 days stay in a paediatric clinic with caloric restriction to 600 kcal per daya

None

3 y

21 days stay in a specialised clinic for metabolic disorders and Prader-Willi syndromeb

None

4 y 2 m

14 days stay in a specialised clinic for Tomatis Listening Therapyc

None

10 y 4 m

2 years outpatient psychotherapy for mother and child

None

11 y 5 m

6 weeks stay in a rehabilitation clinic focusing obesityd

− 10.7 kg (− 9.86%), followed by weight regain

14 y 7 m

6 months stay in a rehabilitation clinic with obesity long-term therapye

− 15.6 kg (− 6.41%), followed by 9.3 kg weight regain within 1 month

18 y 1 m

Leaving the parental home and moving into an assisted living community

− 8 kg (+ 4.26%)

18 y 3 m

2 years outpatient psychotherapy

None

18 y 4 m

Bariatric surgery: sleeve gastrectomyf

− 38 kg (− 20.13%), followed by weight regain (overall weight reduction, 16 kg (− 8.47%))

Patient 2

Ongoing

Restrictive food intake and motivation for physical activity

None

1 y 11 m

15 days stay in a paediatric clinic with daily 800 kcal caloric restrictiona

None

2 y 9 m

7 weeks stay in a paediatric clinic with daily 400 kcal caloric restrictionb

− 4 kg (− 12.05%)

3 y 10 m

1.5 years outpatient psychotherapy

None

5 y 6 m

1 year inpatient psychotherapyc

− 14 kg (− 29.79%), followed by slow weight regain

6 y 5 m

3 years outpatient psychotherapy

None

9 y 5 m

3 years growth hormone treatment due to short stature and growth hormone deficiency

+ 59 kg (+ 38.8%)

12 y 7 m

4 months stay in a rehabilitation clinic with obesity long-term therapyd

+ 4 kg (+ 4.0%)

12 y 11 m

Regular advice and support from the youth welfare department, psychological care and medical weight control

None

14 y 3 m

Bariatric surgery: gastric bandinge

− 49 kg (− 33.84%)

14 y 4 m

28 days stay in a child and adolescent psychiatry after gastric banding

− 5 kg (− 3.72%)

25 y 0 m

Removal of gastric banding due to band migrationf

+ 15 kg (+ 14.8%) within 4 years

  1. a–fRefer to Fig. 1 and display the time points of interventions and their impact on weight