Defining and identifying predictors of rapid response to pediatric obesity treatment

Abstract

Early weight loss (rapid response [RR]) is associated with better outcomes in adults.Less is known about RR in children enrolled in weight-loss treatment. The aim of the current study was to establish an RR weight-loss threshold following 4 weeks of pediatric obesity treatment and identify characteristics associated with achieving RR. One hundred thirty-seven children aged 8 to 12 with overweight/obesity and parents participated in 6 months of family-based or parent-based treatment. Receiver operating characteristic curves evaluated how weight loss at week 4 related to decreases of 5% at posttreatment and 10% at 6-and 18-month follow-ups of standardized body mass index (BMIz), percentage distance of a child's BMI from the median BMI for sex and age, and percentage above the 95th percentile. Weight loss of 2.4% to 3.4% at week 4 predicted 5% change at posttreatment (AUC's = .68-.75; P's ≤ .002) and 10% change at 6-month follow-up (AUC's = .63-.70; P's ≤ .02). No model was significant at 18-month follow-up. Amount of parent weight (lbs) change at week 4 was associated with child achieving RR. Males and Non-Hispanic Whites were more likely to achieve RR. This threshold could be used to mark early significant progress and guide clinical evaluations of treatment response to paediatric obesity treatment. K E Y W O R D S childhood obesity, family-based intervention, parents, pediatrics

Factors predicting parent engagement in a family-based childhood obesity prevention and control program

“…Similarly, the design did not allow for observation of changes that may occur during program participation that could affect engagement, such as positive changes in weight, behaviors, or family functioning. For instance, participants who experience weight loss or successfully change certain behaviors shortly after participation begins may be more likely to remain engaged [48]. Thus, in addition to using a prospective design to examine predictors of engagement, future studies could benefit from repeated measures designs that collect behavioral or health data during the program, and not just before and after participation.…”

Medication-induced weight gain and advanced therapies for the child with overweight and obesity: An Obesity Medicine Association (OMA) Clinical Practice Statement 2022

“…Fig. 12 shows the expected pathway of early and delayed intervention with the disease of obesity demonstrating that the earlier the successful intervention, the less the risk of developing health consequences [ [144] , [145] , [146] , [147] ].

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Novel dietary interventions for adolescents with obesity: A narrative review

“…The intervention focus is on the young person, and the implications of such approaches are not known. Parental support may improve outcomes for adolescents undergoing weight management, 66 and engaging caregivers, if appropriate, in their own weight loss efforts may facilitate additional support 39,67,68 . Additionally, the nature of parental support might be important, 69,70 although not all caregivers will have the capacity to support the adolescent.…”

“…They offer an alternative treatment option for adolescents not responding to conventional interventions, adolescents with obesity‐related comorbidities or severe obesity, and/or when rapid or substantial weight loss is required 8 . Additionally, early weight loss is a predictor of longer‐term treatment success, 38,39 and novel dietary interventions, such as those commencing with a VLED, may improve outcomes. Importantly, novel diets may also bridge the divide between conventional obesity treatment, and pharmacological and surgical approaches.…”