For healthcare providers
National care programme and combined lifestyle intervention
Evira is built to support the treatment that is already recommended. Here we summarise what the national care programme says about KLB, treatment intensity, and digital treatment support – and where Evira fits in.
What is KLB?
Combined lifestyle treatment (KLB) is the basis of all childhood obesity treatment and aims for healthy weight development. According to the care programme, KLB should be individualised and age-adapted, structured, long-term, and evidence-based, and can be carried out through physical visits or remotely, individually or in groups.
The care programme describes that the intensity of the treatment is crucial for the outcome and that the treatment needs to correspond to at least 26 hours per year. Maintaining regular treatment contact is also described as a challenge.
What the care programme says about digital treatment support
The care programme describes digital treatment support as developed to complement physical visits, with a greater ability to maintain close treatment contact with the family. To use them, a clear agreement is required to manage costs, personal data, care responsibility, and patient data.
To maintain regular continuity, physical visits can, according to the care programme, be combined with digital treatment visits and short follow-ups via phone or video.
Obesity is described as a chronic disease. Children who achieve good treatment results should therefore continue to be followed regularly with annual check-ups.
Source: National care programme for the treatment of obesity in children and adolescents (2023-05-15).
Documented effect of various treatment interventions
The care programme compiles documented effects for treatment interventions with a minimum treatment period of 12 months. Evira is included in the compilation.
- Combined lifestyle intervention (4–18 years)−0,13 till −0,15 BMI SDS
- Intensive combined lifestyle intervention, 26–52 hours/year (4–18 years)−0,17 till −0,30 BMI SDS
- SOFT – Standardised Obesity Family Therapy, individual (6–17 years)−0,12 BMI SDS
54 children, 11.9 years, BMI SDS 3.7 (Karlberg), 19% dropout
- SOFT – Standardised Obesity Family Therapy, group (12–19 years)−0,09 BMI SDS
72 children, 14.8 years, BMI SDS 3.3 (Karlberg), 10% dropout
- Södertäljemodellen – parent education and weight school (6–13 years)−0,24 BMI SDS
1,334 children, 9.3 years, BMI SDS 2.7 (IOTF), 41% dropout
- Structured family support programme, Mer och Mindre (4–6 years)−0,30* BMI SDS
87 children, 5.2 years, BMI SDS 3.0 (IOTF), 30% dropout
- Digital support system, EVIRA + combined lifestyle intervention (4–18 years)−0,30 BMI SDS
107 children, 11.9 years, BMI SDS 2.8 (IOTF), 36% dropout
- Liraglutide + combined lifestyle treatment (12–18 years)−0,22 BMI SDS
125 children, 14.6 years, BMI SDS 3.1 (IOTF), 19% dropout
Mean change in BMI SDS after at least 12 months of treatment according to Table 5, Documented effect of various treatment interventions in National care programme for the treatment of obesity in children and adolescents (2023-05-15). Obesity surgery is described in the care programme but is not included in the figure.
* Parent support programmes with and without follow-up phone calls show a decrease in BMI SDS of 0.54 and 0.11 respectively after 12 months.
The results are from different studies with different populations and study designs and should not be interpreted as a direct comparative study between treatment methods.
Evira's row in the table
Digital support system, EVIRA + combined lifestyle intervention · 4–18 years · −0,30 BMI SDS · 107 children · mean age 11.9 years · BMI SDS 2.8 (IOTF) · 36% dropout · at least 12 months of treatment.