title: Is BMI alone a sufficient outcome to evaluate interventions for child obesity?
abstract: BACKGROUND
  BMI is often used to evaluate the effectiveness of childhood obesity interventions, but such interventions may have additional benefits independent of effects on adiposity. We investigated whether benefits to health outcomes following the Mind, Exercise, Nutrition…Do It! (MEND) childhood obesity intervention were independent of or associated with changes in zBMI.
  
  
  METHODS
  A total of 79 obese children were measured at baseline; 71 and 42 participants were followed-up at 6 and 12 months respectively, and split into four groups depending on magnitude of change in zBMI. Differences between groups for waist circumference, cardiovascular fitness, physical and sedentary activities, and self-esteem were investigated.
  
  
  RESULTS
  Apart from waist circumference and its z-score, there were no differences or trends across zBMI subgroups for any outcome. Independent of the degree of zBMI change, benefits in several parameters were observed in children participating in this obesity intervention.
  
  
  CONCLUSIONS
  We concluded that isolating a single parameter like zBMI change and neglecting other important outcomes is restrictive and may undermine the evaluation of childhood obesity intervention effectiveness.
authors.affiliation: Mytime MEND, Bromley, Kent, United Kingdom.
authors.forename: Maria
authors.initials: M
authors.lastname: Kolotourou
authors.forename: Duncan
authors.initials: D
authors.lastname: Radley
authors.forename: Paul
authors.initials: P
authors.lastname: Chadwick
authors.forename: Lindsey
authors.initials: L
authors.lastname: Smith
authors.forename: Stavros
authors.initials: S
authors.lastname: Orfanos
authors.forename: Venediktos
authors.initials: V
authors.lastname: Kapetanakis
authors.forename: Atul
authors.initials: A
authors.lastname: Singhal
authors.forename: Tim J
authors.initials: TJ
authors.lastname: Cole
authors.forename: Paul M
authors.initials: PM
authors.lastname: Sacher
mesh_terms: D015992:Body Mass Index; D002648:Child; D002664:Child Nutritional Physiological Phenomena; D019317:Evidence-Based Medicine; D005260:Female; D006801:Humans; D008297:Male; D009752:Nutritional Status; D063766:Pediatric Obesity / Q000453:epidemiology / Q000517:prevention & control*; D010809:Physical Fitness; D012649:Self Concept; D013997:Time Factors; D006113:United Kingdom / Q000453:epidemiology; D055105:Waist Circumference