These 3 Strategies Can Help Manage Weight Among Youth With Obesity

Practitioners at obesity management clinics can take 3 steps to more effectively reduce the body mass index (BMI) of their pediatric patients: improve follow-up rates, address mental health concerns, and promote year-round physical activity, according to new research.

To reach this conclusion, the researchers studied data on 769 individuals aged 8 to 17 years with obesity who had visited a tertiary care obesity management clinic in Chicago, Illinois, between July 2014 and December 2016. Data on the patients’ first and 12 ± 3-month follow-up visits were analyzed. 

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The researchers also collected information on the patients’ anthropometrics, demographics, medical/psychological history, reported diet patterns, and participation in moderate/vigorous physical activity. The researchers evaluated for associations between these factors and the patients’ reduction of BMI percent of the 95th percentile (BMIp95) by 5 or more points after 1 year.

In all, 184 patients had a 1-year follow-up. Of these individuals, 62.0% were boys, 65.8% were Hispanic, 77.7% had public insurance, and 33.2% had a decrease in BMIp95 by 5 or more points. 

Those who had a decrease in BMIp95 by 5 or more points were more likely to have completed an initial visit in the summer (April through September) and less likely to have had depression at presentation. 

“When significant depressive symptoms are noted in a patient with obesity, care should substantially focus on evaluation and treatment of the depression to eliminate this barrier from achieving activity and behavior changes,” according to the researchers.

After 1 year, the patients who had a decrease in BMIp95 by 5 or more points were also more likely to have had increased physical activity by 1 to 2 days a week or by 3 or more days a week. 

“Both primary care and obesity specialist pediatric providers can more accurately advise patients that a key to BMI reduction involves increased physical activity and perhaps elevate the importance of increases in physical activity during obesity care counseling,” the researchers concluded.

The researchers determined that demographic and dietary factors were not significantly associated with BMIp95 group status.

—Colleen Murphy

Reference:

Gorecki MC, Feinglass JM, Binns HJ. Characteristics associated with successful weight management in youth with obesity. J Pediatr. 2019;212:35-43. doi:10.1016/j.jpeds.2019.05.039.