Objective Obesity and overweight-related disease are an increasing problem in the pediatric and adolescent populations. The prevalence of overweight pediatric patients is up to 20% in the United States. Our objective was to evaluate the efficacy of our pediatric weight management program to determine how to further improve the program.
Background The weight management program was a 12-week multidisciplinary program including physicians, nurses, physical therapists, and a nutritionist. Patients aged 6 to 16 with no or mild comorbidities were referred to the program, which included weekly weights, blood pressure checks, dietary counseling, and supervised exercise. Our pilot program was composed of 97 patients with a mean age of 11.7 years (6.1-17), including 40 boys (41%) and 58 girls (59%.).
Methods Evaluation of our pilot program included retrospective chart review and follow-up telephone surveys. Eighty-four patients were selected for review. Thirteen patients did not follow up after initial evaluation and are excluded from this analysis. Initial and ending body mass index (BMI) and blood pressures were compared. Because the patient's height was recorded only at the beginning of the program, end-point BMIs were recalculated using the initial height adjusted for age-appropriate growth velocity. Blood pressures were compared before and after the program. Telephone surveys sought feedback and follow-up data.
Results Initial mean BMI was 37.1 kg/m2 (21.4-54.4.) Final mean BMI was 36.9 kg/m2 for a mean difference of −0.208 (−2.87 to +2.38, p = .057). Changes in blood pressure were also evident, with a higher percentage of children having normal blood pressure or prehypertension at program end compared with the initial visit (initial vs end: 31 vs 55% normal blood pressure; 15 vs 27% prehypertension; 53 vs 18% hypertension). Telephone surveys resulted in 24.6% patients reporting weight maintenance, 17.5% further weight loss, 54.3% weight gain, and 3.6% unsure of weight status following the program.
Conclusions Although dramatic reductions of BMI were not seen, weight maintenance can be an important end point in reducing weight-related comorbidity. The pilot program used progressive improvement of nutrition and physical activity, so only modest improvements were expected. Both the reductions in prehypertension/hypertension and reported continued weight loss/maintenance are encouraging.
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