Long and Short of It: Early Response Predicts Longer-Term Outcomes in Pediatric Weight Management

Amy C Gross; Alexander M Kaizer; Aaron S Kelly; Kyle D Rudser; Justin R Ryder; Claudia R Borzutzky; Melissa Santos; Jared M Tucker; Jennifer K Yee; Claudia K Fox; POWER Work Group

doi:10.1002/oby.22367

Long and Short of It: Early Response Predicts Longer-Term Outcomes in Pediatric Weight Management

Obesity (Silver Spring). 2019 Feb;27(2):272-279. doi: 10.1002/oby.22367.

Authors

Amy C Gross^{1

2}, Alexander M Kaizer^{2

3}, Aaron S Kelly^{1

2}, Kyle D Rudser^{2

4}, Justin R Ryder^{1

2}, Claudia R Borzutzky⁵, Melissa Santos⁶, Jared M Tucker^{7

8}, Jennifer K Yee⁹, Claudia K Fox^{1

2}; POWER Work Group

Affiliations

¹ Department of Pediatrics, University of Minnesota Medical School, Minneapolis, Minnesota, USA.
² Center for Pediatric Obesity Medicine, University of Minnesota Medical School, Minneapolis, Minnesota, USA.
³ Department of Biostatistics and Informatics, Colorado School of Public Health, University of Colorado-Anschutz Medical Campus, Aurora, Colorado, USA.
⁴ Division of Biostatistics, University of Minnesota School of Public Health, Minneapolis, Minnesota, USA.
⁵ Department of Pediatrics, Keck School of Medicine of USC, Diabetes and Obesity Program, Children's Hospital Los Angeles, Los Angeles, California, USA.
⁶ The Pediatric Obesity Center, Connecticut Children's Medical Center, Hartford, Connecticut, USA.
⁷ Helen DeVos Children's Hospital, Grand Rapids, Michigan, USA.
⁸ Department of Pediatrics and Human Development, Michigan State University, Grand Rapids, Michigan, USA.
⁹ Department of Pediatrics, Division of Endocrinology, Harbor-UCLA Medical Center, The Los Angeles Biomedical Research Institute at Harbor-UCLA, Torrance, California, USA.

Abstract

Objective: This study aimed to examine whether 1-month BMI improvement is predictive of superior 6- and 12-month BMI changes in a national sample of youth in pediatric weight management treatment.

Methods: Participants were 4- to 18-year-olds from the Pediatric Obesity Weight Evaluation Registry, a prospective study collecting data from 31 pediatric weight management programs across the United States. Response at 1 month was defined as ≥ 3% BMI reduction; success at 6 and 12 months was defined as ≥ 5% BMI reduction from baseline. Analyses used linear and logistic regression with robust variance estimation.

Results: Primary analyses were completed with 687 participants (mean age 12.2 years). One-month responders demonstrated significant improvements in BMI compared with nonresponders at 6 months (BMI, -2.05 vs. 0.05; %BMI, -5.81 vs. 0.23; P < 0.001 for all) and 12 months (BMI, -1.87 vs. 0.30; %BMI, -5.04 vs. 1.06; P < 0.001 for all). The odds of success for 1-month responders were 9.64 (95% CI: 5.85-15.87; P < 0.001) times that of nonresponders at 6 months and 5.24 (95% CI: 2.49-11.02; P < 0.001) times that of nonresponders at 12 months.

Conclusions: In treatment-seeking youth with obesity, early BMI reduction was significantly associated with greater long-term BMI reduction. Nonresponders may benefit from early treatment redirection or intensification.

Trial registration: ClinicalTrials.gov NCT02121132.

Publication types

Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Body Weight / physiology*
Body Weight Maintenance / physiology*
Child
Child, Preschool
Female
Humans
Male
Pediatric Obesity / therapy*
Prospective Studies
Treatment Outcome

Associated data

ClinicalTrials.gov/NCT02121132

Grants and funding

UL1 TR002494/TR/NCATS NIH HHS/United States