A pediatric weight management program for high-risk populations: a preliminary analysis.
OBJECTIVE
To determine whether a multidisciplinary pediatric weight management program effectively improves BMI, BMI z-score, and cardiovascular risk factors (CVRFs) in high-risk populations.


METHODS
A retrospective chart review was performed on children seen in the NEW Kids Program at the Children's Hospital of Wisconsin, a family-based clinic that treats pediatric obesity using medical management, nutrition education, behavioral intervention, and physical activity. Inclusion criteria were program participation for >or=9 months and >4 visits. Analyses were performed to identify factors associated with pre- to postintervention changes in BMI, BMI z-score, and CVRF laboratory values.


RESULTS
A total of 66 patients met inclusion criteria; the mean age was 11 years (s.d.+/-3.4), 56% were racial/ethnic minorities, 45% were Medicaid recipients, 48% resided in impoverished communities, and 38% had a BMI >or=40 kg/m(2). Of the 66 patients, 91% had more than one weight-related comorbidity, 88% had CVRFs, and the preintervention mean BMI was 37 kg/m(2). After the intervention, there was an overall increase in absolute BMI, but a small, yet significant decrease in BMI z-score (mean -0.03+/-0.16; P<0.05). There were significant pregroup to postgroup improvements in total cholesterol, low-density lipoprotein, and triglycerides levels (P<0.05). Insurance coverage, race/ethnicity, gender, age, and initial BMI were not significantly associated with changes in BMI or BMI z-score.


CONCLUSIONS
A multidisciplinary pediatric weight management program can improve the weight status of high-risk populations, including minorities, Medicaid recipients, patients with multiple comorbidities and CVRFs, and the severely obese.
Skelton
Joseph A
JA
Division of Pediatric Gastroenterology and Nutrition, Department of Pediatrics, Medical College of Wisconsin, Milwaukee, Wisconsin, USA. jskelton@wfubmc.edu
DeMattia
Laure G
LG
Flores
Glenn
G
D000293:Adolescent; D001521:Behavior Therapy; D015992:Body Mass Index; D031204:Caloric Restriction; D002318:Cardiovascular Diseases / Q000209:etiology / Q000517:prevention & control*; D002648:Child; D002664:Child Nutritional Physiological Phenomena; D005081:Exercise Therapy; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008019:Life Style; D008297:Male; D008484:Medicaid; D008913:Minority Groups; D009765:Obesity / Q000150:complications / Q000178:diet therapy / Q000208:ethnology / Q000628:therapy*; D010348:Patient Care Team; D010353:Patient Education as Topic; D010865:Pilot Projects; D011203:Poverty; D015397:Program Evaluation; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014481:United States; D014922:Wisconsin