Aim. “The combined DAK therapy for obesity in children and adolescents” combines a 6-week inpatient with a 10.5-month outpatient treatment. The aim of the study is to evaluate whether the therapeutic achievements are maintained two and four years after intervention. Method. All subjects who had participated in the 12-month program in 2004/2005 were included in the follow-up study. Body weight, height, and physical fitness were assessed through direct measurements, behaviour, and quality of life by self-report questionnaires. Statistical analysis is based on an intention-to-treat analysis. Results. The response rate after three years was 63.4% and 42.2% after five years. Within three years, participants reduced their BMI-SDS significantly by 0.20 (SD 0.49) and by 0.15 (SD 0.51) within five years. Significant positive changes could be observed with respect to the participants eating behaviour. Similarly, the food intake, particularly the consumption of calorie-reduced beverages, increased significantly while that of nonrecommended foods decreased. Improvement was also seen in the subjective quality of life as well as several aspects of self-perception. Conclusion. Compared to baseline data, significant reduction of BMI-SDS and positive changes of health-related behaviours could be observed even three and five years after the start of the initial program. 1. Introduction The prevalence of childhood obesity and associated comorbidities is high in developed countries and is still increasing in many countries. The German Health Interview and Examination Survey for Children and Adolescents (KIGGS) conducted by the Robert Koch Institute revealed that 8.7% of the 3- to 17-year-old children in Germany are overweight and an additional 6.3% are already obese [1]. In the United States, the prevalence of obesity and overweight has tripled in the last 30 years [2]. According to the cross-sectional analysis of Ogden and colleagues published in 2012, the prevalence of obese children and adolescents in the United States is 16.9% [3]. In some European countries, the prevalence of obesity is as high as 35% [4]. However, recently, this rise in obesity prevalence appears to be tapering off in several countries including the United States [3], Germany [5], and Greece [6]. Pediatric obesity may cause metabolic abnormalities such as hyperlipidemia, hypertension, impaired glucose tolerance, or even type 2 diabetes early in childhood [7, 8]. Recently, a review from van Vliet and coworkers compared cardiometabolic risk factors such as impaired fasting glucose/impaired glucose
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