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Predicting weight loss and maintenance in overweight/obese pediatric patients
Susanna Wiegand1, Klaus-Michael Keller, Thomas Lob-Corzilius
1Department of Pediatric Endocrinology and Diabetology, Charité University Medicine, Berlin, Germany.
Insights
Long-term weight patterns in overweight children show varied outcomes. Interventions before puberty appear most effective for sustained weight management in pediatric obesity.
Area of Science:
- Pediatric Endocrinology
- Obesity Research
- Public Health
Background:
- Pediatric lifestyle interventions show short-term success in obese patients.
- Long-term effects of these interventions are understudied in Europe.
- This study examines long-term weight changes in a Central European pediatric cohort.
Purpose of the Study:
- To investigate long-term weight trajectories in overweight children.
- To identify sociodemographic predictors of weight change in pediatric obesity.
- To evaluate the effectiveness of interventions over time.
Main Methods:
- Retrospective analysis of the APV database (Adiposity Patients Verlaufsbeobachtung).
- Included 29,181 patients (5-25 years old) with BMI ≥ 90th percentile from 157 centers.
- Analyzed BMI standard deviation scores (BMI-SDS) over a 2-year follow-up using logistic regression.
Main Results:
- Five distinct weight trajectories were identified: 'rapid weight loss', 'delayed success', 'cycling weight', 'initial weight loss and weight rebound', and 'no weight loss throughout'.
- 40.7% of patients showed no weight loss, while 23.4% achieved rapid weight loss.
- Younger age and male sex were associated with better weight reduction and maintenance.
Conclusions:
- Intervention before puberty is promising for long-term weight maintenance in overweight children.
- New strategies are needed to enhance long-term treatment success for children with poorer outcomes.
- Early intervention is key for sustained pediatric obesity management.
Background:
Pediatric lifestyle interventions have positive short-term effects on obese patients. Studies on long-term effects are still scarce in Europe. We investigated long-term weight patterns and sociodemographic predictors of a weight change in a large Central European (Germany, Austria and Switzerland) overweight pediatric cohort.
Methods:
The APV (Adiposity Patients Verlaufsbeobachtung) database was retrospectively analyzed; 157 specialized childhood obesity centers contributed standardized data of 29,181 patients [body mass index (BMI) ≥ 90th percentile; 5-25 years old] presenting between 2000 and 2012. BMI standard deviation scores (BMI-SDS) were analyzed in a 2-year follow-up and grouped according to BMI-SDS changes. Multiple logistic regression analyses were conducted to assess associations between sociodemographic factors and weight patterns.
Results:
2-year follow-up data were available in 3,135 patients (54.6% female). Five distinct weight trajectories 'rapid weight loss' (n = 735, 23.4%), 'delayed success' (n = 697, 22.2%), 'cycling weight' (n = 43, 1.4%), 'initial weight loss' and 'weight rebound' (n = 383, 12.2%) and 'no weight loss throughout' (n = 1,277, 40.7%) best characterized long-term BMI-SDS changes. Younger and male patients were more likely to reduce weight and maintain weight loss.
Conclusions:
Our results suggest that an intervention before the onset of puberty seems promising for long-term weight maintenance in overweight children. Thus, new concepts are needed to improve long-term treatment success in patients with lower success rates.
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