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Published on: August 21, 2015
Family-based obesity treatment in children with disabilities
Callie L Brown1, Megan B Irby2, Timothy T Houle3
1Department of Pediatrics, Wake Forest School of Medicine, Winston-Salem, NC.
Insights
Pediatric weight management programs are effective for children with and without cognitive disabilities (CD). Family-centered care leads to similar or better weight status changes in children with CD.
Area of Science:
- Pediatric Endocrinology
- Obesity Medicine
- Developmental Pediatrics
Background:
- Pediatric obesity is a significant public health concern.
- Effective weight management strategies are crucial for children with and without developmental challenges.
- Tertiary-care programs offer specialized interventions for complex cases.
Purpose of the Study:
- To compare the effectiveness of an interdisciplinary, family-centered pediatric weight management program for children with and without cognitive disabilities (CD).
- To evaluate treatment outcomes, including changes in body mass index (BMI) z-score and attrition rates.
Main Methods:
- Retrospective analysis of 453 patients from a tertiary-care pediatric weight management clinic.
- Patients were categorized into groups with and without cognitive disabilities (CD).
- Longitudinal data on BMI z-score changes and treatment attrition were extracted from electronic health records.
Main Results:
- No significant differences in baseline BMI or BMI z-score between groups.
- Attrition rates were similar for children with and without CD.
- Children with CD showed a statistically significant greater reduction in BMI z-score compared to those without CD (-0.07 vs -0.03, P = .029).
Conclusions:
- Interdisciplinary, family-centered pediatric weight management programs yield comparable or superior outcomes for children with cognitive disabilities (CD).
- The patient-centered approach, leveraging individual strengths, likely contributes to the success of these programs.
- These findings support the inclusive application of specialized weight management interventions for diverse pediatric populations.
Objective:
To assess the relative effectiveness of an interdisciplinary, family-centered, tertiary-care pediatric weight management program for the treatment of patients with and without cognitive disabilities (CD).
Methods:
Retrospective analysis of the clinical database of a tertiary-care pediatric weight management clinic (n = 453), extracting data from electronic health records including longitudinal change in weight status (body mass index [BMI] z-score) and frequency of attrition from treatment. Upon review of medical records, children enrolled in the treatment program were classified as having no CD (n = 342) or CD (n = 111).
Results:
At baseline, there were no between-group differences in BMI or BMI z-score. After 4 months of treatment, 66% (299) of patients remained enrolled, and complete case data were available for 219 children in final analyses. There were no statistically significant differences in attrition between the 2 groups (no CD vs CD). Mean change in BMI z-score across all groups was -0.03 ± 0.13 (P < .001). Change in BMI z-score was significantly greater among patients with CD (-0.07 ± 0.15) compared to those without CD (-0.03 ± 0.12) (difference 0.04, 95% confidence interval 0.005-0.08, P = .029). These change estimates were observed after adjusting for processes potentially associated with attrition.
Conclusions:
Children with CD treated in an interdisciplinary, family-centered obesity clinic had similar or better outcomes compared to peers without CD. This success may be attributable to the patient-centered nature of this behavioral weight management program, which focused on leveraging the unique strengths and capabilities of each individual patient and family.
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