Is BMI Alone a Sufficient Outcome To Evaluate Interventions for Child Obesity?

Abstract

Background: BMI is often used to evaluate the effectiveness of childhood obesity interventions, but such interventions may have additional benefits independent of effects on adiposity. We investigated whether benefits to health outcomes following the Mind, Exercise, Nutrition.Do It! (MEND) childhood obesity intervention were independent of or associated with changes in zBMI.Methods: A total of 79 obese children were measured at baseline; 71 and 42 participants were followed-up at 6 and 12 months respectively, and split into four groups depending on magnitude of change in zBMI. Differences between groups for waist circumference, cardiovascular fitness, physical and sedentary activities, and self-esteem were investigated.Results: Apart from waist circumference and its z-score, there were no differences or trends across zBMI subgroups for any outcome. Independent of the degree of zBMI change, benefits in several parameters were observed in children participating in this obesity intervention.Conclusion: We concluded that isolating a single parameter like zBMI change and neglecting other important outcomes is restrictive and may undermine the evaluation of childhood obesity intervention effectiveness.

Continued attendance for paediatric weight management: A multicentre, qualitative study of parents' reasons and facilitators

“…Being able to observe tangible changes and having positive feedback from healthcare professionals on progress achieved led parents to perceive the programme as effective and enhanced families' motivation for treatment. Although “success” in PWM has been traditionally measured in terms of improvements in weight status, our data suggest that families hold a broader definition of success, which aligns with contemporary views of managing paediatric obesity and previous research on parental motivation (eg, help improve children's psychosocial health) for participating in programmes for PWM . Experiences of success may also enhance parents' and children's perceived capability to make lifestyle changes, which can lead to actual lifestyle changes and improved weight status …”

Treatment of overweight and obesity in children and youth: a systematic review and meta-analysis

“…In addition, Kolotourou and colleagues argue BMI is too restrictive an outcome, and that additional outcomes such as fitness, selfesteem, physical and sedentary activities should be measured. 66 Four studies evaluated the sustainability of changes in BMI after completion of weight-management programs. Unfortunately, after 6 months, no impact of the interventions on BMI was identified.…”

The effect of before school physical activity on child development: A study protocol to evaluate the Build Our Kids Success (BOKS) Program

“…In response, calls have been made to examine the impact of physical activity on children outside the realm of BMI [5,6].…”

“…Innovative school based physical activity programs have been cited as a promising approach to improve total daily physical activity levels of youth [21][22][23]. Specifically, physical activity programs A C C E P T E D M A N U S C R I P T ACCEPTED MANUSCRIPT 5 implemented before school have also shown promising results including on-task behavior and the management of ADHD behaviors [14,24].…”