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First-month response to pediatric weight management predicts long-term BMI

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January 28, 2019

Children and adolescents enrolled in weight-management programs who respond quickly are more likely to achieve greater long-term reductions in BMI compared with those without an early response, according to findings published in Obesity.

Amy Gross

“We often see vast individual variability in how people respond to weight-management treatment,” Amy Gross, PhD, LP, BCBA-D, an assistant professor of pediatrics at the University of Minnesota Medical School in Minneapolis, told Endocrine Today. “That is, even using the same treatment plan, some individuals show BMI reduction while others may show BMI increase. Although we know there is variability in how people will respond to treatment, research has not been able to identify clear ways to predict how different people will respond to different treatment approaches.”

Gross and colleagues used data from the Pediatric Obesity Weight Evaluation Registry for analysis. The registry is a prospective study that includes data from 31 multicomponent pediatric weight-management programs in the U.S. Data from 687 participants aged 4 to 18 years (mean age, 12.2 years; 54.9% girls; mean BMI, 33.4 kg/m2) were included. Algorithms were used to determine BMI measurements at 1 month, 6 months and 12 months. Participants were considered responsive to treatment if they achieved at least a 3% reduction in BMI at 1 month and a 5% reduction at 6 and 12 months.

Early response to treatment at 1 month was reported in 15.9% of participants (n = 109), with early responders achieving an average reduction of 1.62 kg/m2 in BMI. A marginal gain of 0.03 kg/m2 was noted, on average, among nonresponders at 1 month.

After 6 months, initial responders lost a greater percentage of baseline BMI (–5.81%) compared with those who did not respond at 1 month (0.23%; P < .001). A similar difference was found in the percentage change in BMI between initial responders (–5.04%) and nonresponders (1.06%) at 12 months (P < .001). The researchers noted that early responders were 9.64 times more likely to achieve at least 5% BMI reduction at 6 months compared with nonresponders (95% CI, 5.85-15.87) and 5.24% more likely to do so at 12 months (95% CI, 2.49-11.02).

“This research helps us by showing that early response may be a good predictor of how people will continue to respond to a particular treatment plan,” Gross said. “If a person does not respond to a treatment initially, it is probably a good idea to consider another approach.” – by Phil Neuffer

Disclosures: Gross reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.

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