Who benefits most from outpatient lifestyle intervention? An IMI‐SOPHIA study on pediatric individuals living with overweight and obesity

Abstract

ObjectiveThe first‐line approach for childhood obesity is lifestyle intervention (LI); however, success varies. This study aimed first to identify distinct subgroups of response in children living with overweight and obesity and second to elucidate predictors for subclusters.MethodsBased on the obesity patient follow‐up registry the APV (Adipositas‐Patienten‐Verlaufsdokumentation) initiative, a total of 12,453 children and adolescents (median age: 11.5 [IQR: 9.7–13.2] years; BMI z score [BMIz]: 2.06 [IQR: 1.79–2.34]; 52.6% girls) living with overweight/obesity and participating in outpatient LI were studied. Longitudinal k‐means clustering was used to identify individual BMIz response curve for up to 2 years after treatment initiation. Multinomial logistic regression was used to elucidate predictors for cluster membership.ResultsA total of 36.3% of children and adolescents experienced “no BMIz loss.” The largest subcluster (44.8%) achieved “moderate BMIz loss,” with an average delta‐BMIz of −0.23 (IQR: −0.33 to −0.14) at study end. A total of 18.9% had a “pronounced BMIz loss” up to −0.61 (IQR: −0.76 to −0.49). Younger age and lower BMIz at LI initiation, larger initial BMIz loss, and less social deprivation were linked with higher likelihood for moderate or pronounced BMIz loss compared with the no BMIz loss cluster (all p < 0.05).ConclusionsThese results support the importance of patient‐tailored intervention and earlier treatment escalation in high‐risk individuals who have little chance of success.

Clinical characteristics and outcomes of children, adolescents and young adults with overweight or obesity and mental health disorders

“…In this study, we used data from children, adolescents and young adults with overweight or obesity from the Adiposity Patient Registry (APV), a prospective standardized multicentre database used by inpatient and outpatient specialized centers for obesity care in Germany and Austria [ 21 ]. The APV initiative is open to all interested centers providing care for individuals living with overweight or obesity.…”

Bedeutung der stationären Rehabilitation von Kindern und Jugendlichen mit Adipositas

“…Betrachtet man das Ausmaß der Adipositas bei Rehabilitationsbeginn, so zeigt sich in den Jahren 2010 bis 2022 ein ansteigender Im Hinblick auf den BMI-Erfolg ist zu berücksichtigen, dass das Alter und der Ausgangs-BMI-SDS bei stationär behandelten Patient*innen grundsätzlich deutlich höher sind als bei ambulant behandelten [10,18], und der Trend beim BMI-SDS bei beiden Behandlungsansätzen weiter ansteigt [11]. Als weitere Einflussfaktoren werden der sozioökonomische Status und der Migrationshintergrund beschrieben [10,12]. Der Anteil an Kindern und Jugendlichen mit Migrationshintergrund in der Rehabilitation repräsentiert zwar noch nicht den Bevölkerungsquerschnitt, zeigt aber ebenfalls eine steigende Tendenz.…”