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Original Article

Improvements in obesity-related measures among Asian patients with severe obesity following a structured lifestyle intervention

Pei-Shan Chen¹  , Shu-Mei Tsai²  , Chih-Hsuan Chang³  , Hui-Ru Yang⁴  , Yen-Ju Huang¹  , Hsiang-Yin Liu¹  , Kai-Chi Chang⁴  , Huey-Ling Chen^5,6 

¹Division of Physical Therapy, Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Taipei, Taiwan
²Department of Dietetics, National Taiwan University Hospital, Taipei, Taiwan
³Department of Clinical Psychology Center, National Taiwan University Hospital, Taipei, Taiwan
⁴Department of Pediatrics, National Taiwan University Hospital, Taipei, Taiwan
⁵Hepatitis Research Center, National Taiwan University Hospital, National Taiwan University Children’s Hospital, Taipei, Taiwan
⁶Department of Medical Education and Bioethics, National Taiwan University College of Medicine, Taipei, Taiwan

Correspondence Kai-Chi Chang ,Tel: +886-937437239 , Fax: +886-2-23147450, Email: kaichichang@ntu.edu.tw

Received: August 6, 2025; Revised: October 5, 2025   Accepted: October 22, 2025.

Abstract

Background
The rising prevalence of severe obesity among children and adolescents poses a major public health challenge.
Purpose
In this study, we examined the differences in body composition and physical fitness between obese and severely obese Asian youth and evaluated their responses to a customized lifestyle intervention.
Methods
A total of 136 overweight and obese participants (mean age, 11.5±3.0 years) were enrolled in an individualized lifestyle modification program. The participants were stratified by obesity severity, with severe obesity defined as a body mass index (BMI)-for-age ≥120% of the 95th percentile. Body composition and physical fitness were assessed at baseline and after 3 interventional stages. The results were compared between the severely obese group and nonseverely obese group, and the relationships between the changes were analyzed.
Results
Among the obese participants, 46% met the criteria for severe obesity. At baseline, those with severe obesity demonstrated a lower performance percentile in the 1-minute sit-up test (22.1±25.2 vs. 47.9±28.0, P=0.002) and the standing long jump (8.5±14.6 vs. 26.8±23.2, P= 0.003) than their nonseverely obese peers. Participants in both groups showed significant reductions in body fat percentage and preserved skeletal muscle mass after the intervention. Those in the severely obese group achieved greater reductions in weight, BMI, BMI z score, and fat mass, particularly during the first 2 interventional stages, indicating a stronger response to the program.
Conclusion
The severely obese youth showed poorer baseline physical fitness levels but greater improvements in key obesity-related measures following the lifestyle interventions. These findings highlight the potential benefits of early targeted interventions for this high-risk group.

Keywords :Lifestyle, Obesity management, Pediatric obesity, Physical fitness