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J Pediatr. 2019 May;208:57-65.e4. doi: 10.1016/j.jpeds.2018.12.049. Epub 2019 Mar 8.

Health Outcomes of Youth in Clinical Pediatric Weight Management Programs in POWER.

Author information

1
Division of Pediatric Endocrinology and Metabolism, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN.
2
Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH; Department of Pediatrics, University of Cincinnati, College of Medicine, Cincinnati, OH.
3
Department of Pediatrics, University of Illinois College of Medicine at Peoria, Peoria, IL.
4
Department of Pediatrics, Center for Pediatric Obesity Medicine, University of Minnesota Medical School, Minneapolis, MN.
5
Department of Pediatrics, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL; Pediatrics, Feinberg School of Medicine, Northwestern University, Chicago, IL.
6
Department of Pediatrics, Keck School of Medicine of USC, Los Angeles, CA; Diabetes and Obesity Program, Children's Hospital Los Angeles, Los Angeles, CA.
7
Department of Pediatrics, Pediatric Weight Management, Children's Hospital of San Antonio, Baylor College of Medicine, Houston, TX.
8
Department of Pediatrics, University of Cincinnati, College of Medicine, Cincinnati, OH; The Heart Institute, Center for Better Health and Nutrition, Cincinnati Children's Hospital Medical Center, Cincinnati, OH. Electronic address: Shelley.Kirk@cchmc.org.

Abstract

OBJECTIVE:

To describe treatment outcomes of children and adolescents enrolled in the Pediatric Obesity Weight Evaluation Registry, a consortium of multicomponent pediatric weight management programs in the US.

STUDY DESIGN:

This multicenter prospective observational cohort study, established in 2013, includes youth (2-18 years of age) with obesity enrolled from 31 Pediatric Obesity Weight Evaluation Registry (POWER) sites over a 2-year period and followed up to 12 months. Weight status was evaluated by the percentage of the 95th percentile for body mass index (%BMIp95). Associations of weight status outcomes with patient characteristics and program exposure were analyzed with multivariable mixed effects modeling.

RESULTS:

We included 6454 children and adolescents (median age, 11 years; IQR, 9-14 years; 53% white, 32% Hispanic; 73% with severe obesity) who were enrolled in POWER. Median changes in %BMIp95 for this cohort were -1.88 (IQR, -5.8 to 1.4), -2.50 (IQR, -7.4 to 1.8), -2.86 (IQR, -8.7 to 1.9), at 4-6, 7-9, and 10-12 of months follow-up, respectively (all P < .05). Older age (≥12 years), greater severity of obesity, and Hispanic race/ethnicity were associated with better improvement in %BMIp95. A 5-percentage point decrease in %BMIp95 was associated with improvement in cardiometabolic risk factors.

CONCLUSIONS:

Overall, treatment in pediatric weight management programs is associated with a modest median decrease in BMI as measured by change in %BMIp95. Further studies are needed to confirm these findings, as well as to identify additional strategies to enhance the effectiveness of these multicomponent interventions for youth with severe obesity.

TRIAL REGISTRATION:

ClinicalTrials.gov: NCT02121132.

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