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

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.

© 2019 The Obesity Society.

Figures

Figure 1.. Percent change in BMI at 6 months by groups of percent BMI change at 1 month.

Figure Legend 1. # in Group = 1 month BMI category participants. # Loss 5%+ = number per group who lost ≥5% BMI at 6 months. Maintain indicates %BMI change between −1% and 1%. Loss indicates range, e.g., [1,2) indicates %BMI decrease 1% up to 2% (square bracket is inclusive, parenthesis is not).

Figure 2.. Percent change in BMI at 12 months by groups of percent BMI change at 1 month.

Figure Legend 2. # in Group = 1 month BMI category participants. # Loss 5%+ = number per group who lost ≥5% BMI at 12 months. Maintain indicates %BMI change between −1% and 1%. Loss indicates range, e.g., [1,2) indicates %BMI decrease 1% up to 2% (square bracket is inclusive, parenthesis is not).