A clinic-based lifestyle intervention for pediatric obesity: efficacy and behavioral and biochemical predictors of response.
OBJECTIVE
To examine efficacy and predictors of response to a lifestyle intervention for obese youth.


METHODS
Retrospective chart review of 214 children and adolescents aged 8-19 years. Linear regression identified baseline predictors of response (delta BMI z-score) at first and ultimate follow-up visits.


RESULTS
Mean delta BMI z-score from baseline was -0.04 (p < 0.001) at first follow-up and -0.09 (p < 0.001) at ultimate follow-up (median time 10 mo) among 156 children and adolescents. Higher baseline BMI z-score predicted poor response at first and ultimate follow-up, explaining 10% of variance in response. Fasting insulin explained 6% of response variance at first follow-up. delta BMI z-score at the first visit along with baseline BMI z-score explained up to 50% of variance in response at ultimate visit.


CONCLUSIONS
Clinic-based interventions improve weight status. Baseline variables predict only a small proportion of response; response at the first visit is a more meaningful tool to guide clinical decisions.
Madsen
Kristine A
KA
Department Pediatrics, University of California, San Francisco, CA 94118, USA. madsenk@peds.ucsf.edu
Garber
Andrea K
AK
Mietus-Snyder
Michele L
ML
Orrell-Valente
Joan K
JK
Tran
Cam-Tu
CT
Wlasiuk
Lidya
L
Matos
Renee I
RI
Neuhaus
John
J
Lustig
Robert H
RH
D000293:Adolescent; D000294:Adolescent Behavior / Q000502:physiology*; D000328:Adult; D000553:Ambulatory Care; D001521:Behavior Therapy / Q000379:methods*; D015415:Biomarkers / Q000032:analysis* / Q000097:blood; D002648:Child; D004035:Diet Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009043:Motor Activity; D009765:Obesity / Q000097:blood / Q000175:diagnosis* / Q000523:psychology / Q000628:therapy*; D011379:Prognosis; D012189:Retrospective Studies; D040242:Risk Reduction Behavior; D013690:Television; D016896:Treatment Outcome; D055815:Young Adult
D015415:Biomarkers