Energy Management for Personalized Weight Reduction (EMPOWER) Program: Three-Year Outcome Data

A P Vidmar; C Fink; B Torres; B Manzanarez; S D Mittelman; C P Wee; C Borzutzky

Energy Management for Personalized Weight Reduction (EMPOWER) Program: Three-Year Outcome Data

Adv Clin Endocrinol Metab. 2019;2(1):47-54. Epub 2019 Mar 10.

Authors

A P Vidmar^{1

2}, C Fink², B Torres², B Manzanarez², S D Mittelman^{2

3}, C P Wee⁴, C Borzutzky⁵

Affiliations

¹ Center for Endocrinology, Diabetes and Metabolism, Department of Pediatrics, Children's Hospital Los Angeles, Los Angeles, USA.
² The Diabetes & Obesity Program, Children's Hospital Los Angeles and The Saban Research Institute, Department of Pediatrics, Children's Hospital Los Angeles, Los Angeles, USA.
³ Department of Pediatrics, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, USA.
⁴ CTSI Biostatics Core, Saban Research Institute, Los Angeles, USA.
⁵ The Diabetes & Obesity Program, Division of Adolescent and Young Adult Medicine, Children's Hospital Los Angeles and Keck School of Medicine of USC, Los Angeles, USA.

PMID: 32699839
PMCID: PMC7375743

Abstract

Background: The current consensus guidelines for management of pediatric obesity recommend clinic-based, family-centered, multi-disciplinary interventions. It is well reported that these programs often only lead to modest improvements in BMI status. The individual factors that differentiate which patient's BMI status will improve vs. worsen remains understudied. A retrospective cohort study was conducted to evaluate the outcomes of EMPOWER clinic and identify the participant specific characteristics that predicted BMI status improvement in this population.

Methods: Youth who completed at least 6 visits in EMPOWER were included. Paired t-test was utilized to evaluate the mean change in zBMI, modified BMIz and %BMI_p95 from baseline to 6^th visit, and multivariate mixed effect models were utilized to analyze effect of baseline characteristics on change in BMI status.

Results: 92 participants were included in the analysis, 87% with severe obesity and 66% Hispanic. At the 6^th visit, there was a significant reduction in zBMI (-0.09 SD, p <0.001) and modified BMIz (-0.0003 SD, p = 0.04) with a small reduction in %BMI_p95 (-1.15 %, p = 0.20). Lower BMI status (p < 0.001) and absence of a comorbidity (p < 0.05) at baseline were predictors of BMI status improvement whereas age, gender, ethnicity, family history of obesity and insurance status were not significant predictors.

Conclusions: Given that implementation of the current guidelines for management of obesity in pediatrics only results in modest BMI status reduction, further investigation is required to understand how the determinants of obesity-related health outcomes can guide development of more innovative, effective interventions for this high risk population.

Keywords: Multi-Disciplinary Clinic; Obesity; Pediatrics; Weight Loss.

Abstract

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