title: Predictors of child weight loss and maintenance among family-based treatment completers.
abstract: OBJECTIVE
  To examine general and treatment-specific predictors of children's weight outcomes during a pediatric weight management trial.
  
  
  METHODS
  One hundred fifty overweight children-69.3% female; M body mass index (BMI) z score (z-BMI) = 2.21 ± 0.30-completed family-based behavioral weight loss treatment (FBT), followed by randomization to social facilitation maintenance (SFM) treatment addressing social support and body image; behavioral skills maintenance treatment (BSM), which extended FBT skills to maintenance; or a control condition with no maintenance treatment. Regression and mixed-effects repeated-measures analysis of covariance (ANCOVA) examined child and parent anthropometric, demographic, and psychosocial variables in predicting relative weight outcomes over short- and long-term follow-ups.
  
  
  RESULTS
  Among FBT completers, lower child baseline z-BMI and age, and greater parent BMI reductions during FBT and baseline self-efficacy, predicted better child relative weight loss following FBT, F(6, 137) = 7.77, p < .001. Higher child-reported post-FBT eating pathology predicted greater relative weight loss in SFM than BSM or control from post-FBT to 2-year follow-up, F(4,255.88) = 3.48, p = .009, whereas higher parent-reported post-FBT social support predicted greater relative weight loss in BSM than control, F(2,141.65) = 3.28, p = .04. Lower parent-reported post-FBT behavioral problems predicted greater relative weight loss in SFM and BSM versus control, F(2,147.84) = 7.37, p < .001; higher problems predicted equivalent outcome across treatments.
  
  
  CONCLUSIONS
  SFM may improve weight outcomes for FBT completers with initially higher eating pathology, whereas extending FBT skills may be effective for those with higher familial support. These results suggest that certain pretreatment variables moderate the effectiveness of different pediatric weight control interventions. Further understanding these findings may help optimally match families to treatments.
authors.affiliation: Department of Psychiatry, The University of Chicago, Chicago, Illinois, USA.
authors.forename: Andrea B
authors.initials: AB
authors.lastname: Goldschmidt
authors.affiliation: Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri, USA.
authors.forename: John R
authors.initials: JR
authors.lastname: Best
authors.affiliation: Department of Internal Medicine, Washington University School of Medicine, St. Louis, Missouri, USA.
authors.forename: Richard I
authors.initials: RI
authors.lastname: Stein
authors.affiliation: Department of Pediatrics, Seattle Children's Hospital Research Institute and University of Washington, Seattle, Washington, USA.
authors.forename: Brian E
authors.initials: BE
authors.lastname: Saelens
authors.affiliation: Department of Pediatrics, University at Buffalo, Buffalo, New York, USA.
authors.forename: Leonard H
authors.initials: LH
authors.lastname: Epstein
authors.affiliation: Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri, USA.|Department of Internal Medicine, Washington University School of Medicine, St. Louis, Missouri, USA.
authors.forename: Denise E
authors.initials: DE
authors.lastname: Wilfley
mesh_terms: D001828:Body Image; D015992:Body Mass Index; D002648:Child; D015928:Cognitive Behavioral Therapy / Q000379:methods; D005190:Family; D005260:Female; D005500:Follow-Up Studies; D006293:Health Promotion; D006801:Humans; D008297:Male; D050177:Overweight / Q000523:psychology / Q000628:therapy; D010290:Parents; D063766:Pediatric Obesity / Q000523:psychology / Q000628:therapy*; D011237:Predictive Value of Tests; D020377:Self Efficacy; D012944:Social Support; D015431:Weight Loss