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Attenuated efficacy of pediatric obesity treatment during the COVID-19 pandemic
Bradley M Appelhans1,2, Simone A French3, Molly A Martin4
1Department of Preventive Medicine, Rush University Medical Center, Chicago, Illinois, USA.
Insights
The COVID-19 pandemic significantly reduced the effectiveness of pediatric obesity treatment. Children treated during the pandemic gained weight, unlike those treated before, highlighting a need for continued support.
Area of Science:
- Pediatric Endocrinology
- Public Health
- Behavioral Medicine
Background:
- Pediatric obesity is a significant public health concern.
- Standard-of-care treatments aim to manage weight in children.
- The COVID-19 pandemic disrupted healthcare delivery and lifestyle factors.
Purpose of the Study:
- To evaluate the impact of the COVID-19 pandemic on the efficacy of a standard-of-care pediatric obesity treatment.
- To compare treatment outcomes before and during the pandemic.
Main Methods:
- Utilized data from an ongoing pediatric obesity treatment trial (n=230, ages 6-12).
- Employed mixed-effects regression models to compare changes in BMI z-score (ΔzBMI) at 3, 6, 9, and 12 months.
- Compared outcomes for children treated before versus during the COVID-19 pandemic.
Main Results:
- A significant difference in ΔzBMI patterns was observed (p < 0.0001).
- Children treated before the pandemic achieved an average weight loss of -0.06 ΔzBMI at 12 months.
- Children treated during the pandemic experienced a weight gain of 0.11 ΔzBMI at 12 months.
- Treatment completion rates did not differ significantly between the two periods (p = 0.30).
Conclusions:
- The COVID-19 pandemic negatively impacted pediatric obesity treatment efficacy.
- Similar reductions in intervention effectiveness may occur in other trials during the pandemic.
- Families managing childhood weight require encouragement to re-engage with structured programs.
Objective:
This study examined whether the efficacy of a standard-of-care pediatric obesity treatment was affected by the COVID-19 pandemic.
Methods:
Analyses leveraged data from an ongoing pediatric obesity treatment trial involving 230 lower-income, urban children aged 6 to 12 years. Mixed-effects regression models compared children who participated in a 12-month weight-management intervention before versus during the COVID-19 pandemic on change from baseline in BMI z score (ΔzBMI) at 3, 6, 9, and 12 months.
Results:
The observed pattern of ΔzBMI was significantly different before versus during the pandemic (χ2 = 22.73, p < 0.0001). Children treated before the pandemic maintained an average weight loss of -0.06 ΔzBMI at 12 months, whereas children treated during the pandemic steadily gained weight over time, averaging a net gain of 0.11 ΔzBMI at 12 months (χ2 = 34.99, p < 0.0001). Treatment session completion did not differ before versus during the pandemic (60.4% vs. 55.7%, respectively; p = 0.30) or account for differences in ΔzBMI.
Conclusions:
Similar reductions in intervention efficacy may be anticipated in other pediatric obesity treatment trials conducted during the COVID-19 pandemic. Many families that have struggled with managing their child's weight during this period may need encouragement to continue engaging in structured weight management as society renormalizes.
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