Health trajectories of children with severe obesity attending a weight management program

Abstract

Purpose The objective of the present study is to examine physical and mental health trajectories of change in youth with severe obesity attending a tertiary care weight management program. It was predicted that younger children would show favourable changes in body mass index (BMI), markers of cardiovascular health, quality of life, and mental health. Methods This 2-year longitudinal study examined health trajectories of children referred to a weight management program at a Canadian paediatric tertiary care centre from November 2010 to December 2013. Participants were 209 of 217 consecutive referred paediatric patients (families) aged 3 to 17 years who met criteria for severe obesity and consented to participate. To maximize generalizability of results, there were no exclusion criteria. Primary outcomes were children’s quality of life and BMI. Secondary outcomes included anxiety, depression, and non–high-density lipoprotein cholesterol levels. Results The findings suggest an improvement in mental health, quality of life, and cardiometabolic health of children and adolescents of all ages over the 2 years of programming. These positive findings were consistent across gender, age, and distance to the program. BMI trajectory changes varied across age cohorts such that younger children showed more favourable outcomes. The retention rate over the 2 years was high at 82.9%. Conclusions This is the first study to show improvements in both physical and mental health outcomes beyond 1 year in a tertiary care setting with a high-risk population of children and youth with severe obesity. Findings highlight the need to examine both mental and physical health outcomes beyond 1 year.

Effectiveness of family based behavioral treatment in an ethnically diverse sample of young children.

“…The interaction of age group and BMI z -scores indicated that younger children started the program with higher BMI z -scores and had significantly greater decline in BMI z -scores across time points than the older children, suggesting that the intervention was particularly effective for this age group. These results are consistent with another recent efficacy study that demonstrated more positive long-term outcomes for younger children in FBBT (Buchholz et al, 2020), which may be due to the greater influence parents and family on young children’s health behaviors (e.g., food choices, opportunities for physical activity), when compared with the influence of the family on youth in middle childhood. This real-world efficacy study did not utilize a comparison group; therefore, we cannot fully rule out the possibility that reductions in weight may represent regression toward the mean.…”

An examination of body esteem and health outcomes in community samples of youth and youth in pediatric weight management

“…Research on children and adolescents has found an association between mental health and quality of life (Stevanovic, 2013). A study that included the current sample of youth found modest improvements in mental health and quality of life over two years in treatment (Buchholz et al, 2020). While this study did not examine how these variables 'move together' in time, it is possible that the increases in mental health and increases in quality of life are happening simultaneously.…”