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

POWER Work Group

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12 Scopus citations

Abstract

Objective: 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. Study design: 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. Results: 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. Conclusions: 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. Trial registration: ClinicalTrials.gov: NCT02121132.

Original languageEnglish (US)
Pages (from-to)57-65.e4
JournalJournal of Pediatrics
Volume208
DOIs
StatePublished - May 2019

Bibliographical note

Funding Information:
Funded by site enrollment fees for their participation in the Pediatric Obesity Weight Evaluation Registry. A.K. receives research support (drug/placebo) from AstraZeneca Pharmaceuticals and serves as a consultant for Novo Nordisk, Orexigen, and Vivus Pharmaceuticals, but does not accept personal or professional income for these activities. The other authors declare no conflicts of interest. The authors gratefully acknowledge the administrative support provided by program coordinator, Deborah Wolff, BS, and technical support provided by regulatory specialist, Katy Fischesser, MS, CCRP, with the Heart Institute Research Core, Cincinnati Children's Hospital Medical Center (CCHMC). In addition, database programmer, Jennifer Andringa, BA; data specialist, Carolyn Powers, BS, RD, CCDM; SAS programmer, Yanhong Liu; and manager, Rachel Akers, MPH, CCDM, with the POWER Data Coordinating Center in the Division of Epidemiology and Biostatistics, CCHMC, have made important contributions to the management and analysis of the POWER data.

Publisher Copyright:
© 2018 Elsevier Inc.

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