Family Dynamics and Longitudinal Trends in Pediatric Obesity: A Real-World Observational Study in a Public Outpatient...

Childhood obesity remains a major public health challenge, and evidence on the outcomes of routine multidisciplinary care in real-world clinical settings remains limited. This study evaluated longitudinal changes in BMI z-score and lifestyle behaviors among children and adolescents with obesity and their caregivers receiving standard multidisciplinary care, and examined the association between caregiver and pediatric BMI over a 6-month follow-up period.

This observational study included 111 caregiver-child dyads (children aged 8-16 years) attending a tertiary public outpatient clinic. Participants received routine multidisciplinary care, including an initial multidisciplinary education session followed by consultations with pediatricians, nutritionists, and physical educators. Assessments were conducted at baseline, 3 months, and 6 months, and included anthropometric, body composition, behavioral, and clinical measures. Longitudinal analyses and correlation tests were performed to examine changes over time and associations between caregivers and pediatric BMI.

Children showed a modest reduction in BMI z-score at 3 months (β = -0.1, p = 0.007), which was not maintained at 6 months (β = -0.04, p = 0.069). No significant changes in dietary or physical activity behaviors were observed. Caregiver measures remained stable throughout follow-up. Moderate caregiver-child BMI correlations were observed across all time points (ρ = 0.274, p = 0.004; ρ = 0.304, p = 0.002). Among participants with complete data, 49.5% were classified as responders, with younger participants more likely to achieve clinical improvement.

In this real-world setting, routine multidisciplinary care was associated with modest improvements in pediatric BMI z-score, while caregiver measures remained stable and caregiver-child BMI associations persisted over time.