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Long and Short of It: Early Response Predicts Longer-Term Outcomes in Pediatric Weight Management
Amy C Gross1,2, Alexander M Kaizer2,3, Aaron S Kelly1,2
1Department of Pediatrics, University of Minnesota Medical School, Minneapolis, Minnesota, USA.
Insights
Early BMI improvement in pediatric weight management predicts better long-term results. Youth showing a 3% BMI reduction in 1 month had significantly greater weight loss at 6 and 12 months.
Area of Science:
- Pediatric Endocrinology
- Obesity Medicine
- Public Health
Background:
- Childhood obesity is a significant public health concern requiring effective weight management strategies.
- Early indicators of treatment response can help tailor interventions for youth.
Purpose of the Study:
- To determine if a 1-month body mass index (BMI) improvement predicts 6- and 12-month BMI changes in pediatric weight management.
- To assess the predictive value of early treatment response in a national cohort of youth.
Main Methods:
- Prospective data from 687 participants (ages 4-18) in the Pediatric Obesity Weight Evaluation Registry.
- 1-month response defined as ≥3% BMI reduction; 6- and 12-month success defined as ≥5% BMI reduction from baseline.
- Linear and logistic regression analyses with robust variance estimation were employed.
Main Results:
- One-month responders showed significantly greater BMI and %BMI reductions at 6 months (e.g., %BMI: -5.81% vs. 0.23%) and 12 months (e.g., %BMI: -5.04% vs. 1.06%) compared to nonresponders.
- The odds of achieving 6-month success were 9.64 times higher for 1-month responders, and 12-month success odds were 5.24 times higher.
Conclusions:
- Early BMI reduction in youth undergoing weight management is a strong predictor of sustained, greater long-term weight loss.
- Nonresponders to initial treatment may require intensified or redirected interventions for improved outcomes.
Objective:
This study aimed to examine whether 1-month BMI improvement is predictive of superior 6- and 12-month BMI changes in a national sample of youth in pediatric weight management treatment.
Methods:
Participants were 4- to 18-year-olds from the Pediatric Obesity Weight Evaluation Registry, a prospective study collecting data from 31 pediatric weight management programs across the United States. Response at 1 month was defined as ≥ 3% BMI reduction; success at 6 and 12 months was defined as ≥ 5% BMI reduction from baseline. Analyses used linear and logistic regression with robust variance estimation.
Results:
Primary analyses were completed with 687 participants (mean age 12.2 years). One-month responders demonstrated significant improvements in BMI compared with nonresponders at 6 months (BMI, -2.05 vs. 0.05; %BMI, -5.81 vs. 0.23; P < 0.001 for all) and 12 months (BMI, -1.87 vs. 0.30; %BMI, -5.04 vs. 1.06; P < 0.001 for all). The odds of success for 1-month responders were 9.64 (95% CI: 5.85-15.87; P < 0.001) times that of nonresponders at 6 months and 5.24 (95% CI: 2.49-11.02; P < 0.001) times that of nonresponders at 12 months.
Conclusions:
In treatment-seeking youth with obesity, early BMI reduction was significantly associated with greater long-term BMI reduction. Nonresponders may benefit from early treatment redirection or intensification.
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