Predictors of successful weight loss in children treated at a community hospital-based tertiary care pediatric weight management program.
Zina C Mc SweeneyMorgan D McSweeneyShirley H HuangSamareh G HillPublished in: Journal of child health care : for professionals working with children in the hospital and community (2021)
Childhood obesity is a major public health concern. However, predictors of successful outcomes for patients treated at multidisciplinary community hospital-based pediatric weight management programs remain poorly understood. We conducted a retrospective analysis to evaluate 633 pediatric patients from ages 2 to 18 at a tertiary pediatric weight management program in 2018. Predictors were evaluated in univariate comparisons, and significant variables were included in a linear regression analysis to identify factors associated with improvements in body mass index relative to the age- and sex-specific 95th percentile body mass index (%BMIp95). We found that male sex and increased number of clinical visits were independently and significantly associated with reductions in %BMIp95. Baseline %BMIp95, age, preferred language, and insurance status were not significant predictors of outcomes. A total of 398 (63%) patients experienced a decrease in %BMIp95 from baseline to follow-up. One quarter (24.8%) of patients experienced a decrease in %BMIp95 of at least 5%, a threshold associated with cardiometabolic improvements. Further, we observed significant improvements in cholesterol, triglycerides, alanine aminotransferase, aspartate aminotransferase, HbA1c, and waist circumference. These findings support a potential need for sex- and gender-tailored care as well as the benefits of increased access to pediatric weight management programs.
Keyphrases
- body mass index
- weight loss
- public health
- weight gain
- end stage renal disease
- physical activity
- newly diagnosed
- healthcare
- ejection fraction
- quality improvement
- mental health
- chronic kidney disease
- tertiary care
- bariatric surgery
- young adults
- prognostic factors
- palliative care
- roux en y gastric bypass
- type diabetes
- patient reported outcomes
- climate change
- insulin resistance
- chronic pain
- human health
- affordable care act