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

• Published in: The Journal of pediatrics Vol. 208; pp. 57 - 65.e4
• Main Authors: Kumar, Seema, King, Eileen C., Christison, Amy L., Kelly, Aaron S., Ariza, Adolfo J., Borzutzky, Claudia, Cuda, Suzanne, Kirk, Shelley, Abraham-Pratt, I., Ali, L., Armstrong, S., Binns, H., Brubaker, J., Cristison, A., Fox, C., Gordon, C., Hendrix, S., Hes, D., Jenkins, L., Joseph, M., Heyrman, M., Liu, L., McClure, A., Hofley, M., Negrete, S., Novick, M., O'Hara, V., Rodrue, J., Santos, M., Stoll, J., Stratbucker, W., Sweeney, B., Tester, J., Walka, S., deHeer, H., Wallace, S., Walsh, S., Wittcopp, C., Weedn, A., Yee, J., Grace, B.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-05-2019
• Subjects: Adolescent; Blood Pressure; Body Mass Index; Child; Cohort Studies; Female; Health Status; Humans; Male; Pediatric Obesity - therapy; Risk Factors; Treatment Outcome; Weight Reduction Programs; HDL-C; BMIp95; DSCF; BMIz; TG; PWM; ALT; ΔBMIp95; POWER; HbA1c; BMI
• ISSN: 0022-3476; 1097-6833
• DOI: 10.1016/j.jpeds.2018.12.049

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.
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.
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.
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.
ClinicalTrials.gov: NCT02121132.