Global Pediatrics (Sep 2023)
Follow up trends among adolescent patients in a weight management program
Abstract
Purpose: According to the World Health Organization, obesity has nearly tripled worldwide since 1975. Childhood and adolescent obesity puts individuals at risk for many comorbidities, and interventions should begin in youth to start managing weight. Our purpose was to analyze if age of patients and engagement [measured by bringing a completed food and exercise log (FEL) to visits] in a multidisciplinary weight management program led patients to be more successful with treatment. Methods: A retrospective chart review was performed of adolescents with obesity in a referral-based outpatient obesity management program at an academic tertiary children's hospital. All patients presenting for new weight management visits in 2015 and 2016 had their data collected from their initial visit as well as each subsequent follow-up visit. Patients were included if they were diagnosed with obesity by having a body mass index (BMI) in the 95th percentile or above. 296 subjects were included. 191 subjects had at least one follow-up visit so analysis related to weight change outcomes were limited to those 191 subjects. Results: 37.5% were elementary school-aged (6 to 11 years), 31.8% middle school-aged (12 to 14 years), and 30.7% high school to college-aged (15 to 20 years). 4.2% of elementary school-aged subjects had significant (>3%) weight loss, 55.6% had no significant weight change, and 40.3% had significant (>3%) weight gain. 12.3% of middle school-aged subjects had significant weight loss, 57.9% had no significant weight change, and 29.8% had significant weight gain. 21.0% of high school and college-aged subjects had significant weight loss, 69.4% had no significant weight change, and 9.7% had significant weight gain. Of those from all ages that had significant weight loss or no significant weight change, FEL were brought to 50% and 70.8% of visits respectively. Of those with significant weight gain, FEL were brought to only 32.1% of visits. The odds ratio of having brought a completed FEL during follow-up visits for those with significant weight gain versus those with no significant weight change was 0.485 (95% CI 0.336-0.700) and for those with significant weight loss versus those with no significant weight change was 0.624 (95% CI 0.402-0.967). Conclusions: Of those with weight gain, the majority were elementary school-aged subjects, and of those with weight loss, the majority were high school to college-aged subjects. This corresponds with recommendations as younger patients are continuing to grow taller and begin puberty while older adolescents should be ending their growth and development and thus encouraged to work on weight loss. Those that brought FEL to more visits were also more likely not to gain weight (no significant change) as compared to those that brought FEL to fewer visits and had significant weight gain. FEL were also brought to fewer visits by those that had weight loss as compared to no change, but the odds of bringing a food log was higher than in those with weight gain. By engaging more with the program, this may indicate that participants remained actively involved with program goals between visits and focused on working towards improved health.
