title: Predicting weight loss and maintenance in overweight/obese pediatric patients.
abstract: BACKGROUND
  Pediatric lifestyle interventions have positive short-term effects on obese patients. Studies on long-term effects are still scarce in Europe. We investigated long-term weight patterns and sociodemographic predictors of a weight change in a large Central European (Germany, Austria and Switzerland) overweight pediatric cohort.
  
  
  METHODS
  The APV (Adiposity Patients Verlaufsbeobachtung) database was retrospectively analyzed; 157 specialized childhood obesity centers contributed standardized data of 29,181 patients [body mass index (BMI) ≥ 90th percentile; 5-25 years old] presenting between 2000 and 2012. BMI standard deviation scores (BMI-SDS) were analyzed in a 2-year follow-up and grouped according to BMI-SDS changes. Multiple logistic regression analyses were conducted to assess associations between sociodemographic factors and weight patterns.
  
  
  RESULTS
  2-year follow-up data were available in 3,135 patients (54.6% female). Five distinct weight trajectories 'rapid weight loss' (n = 735, 23.4%), 'delayed success' (n = 697, 22.2%), 'cycling weight' (n = 43, 1.4%), 'initial weight loss' and 'weight rebound' (n = 383, 12.2%) and 'no weight loss throughout' (n = 1,277, 40.7%) best characterized long-term BMI-SDS changes. Younger and male patients were more likely to reduce weight and maintain weight loss.
  
  
  CONCLUSIONS
  Our results suggest that an intervention before the onset of puberty seems promising for long-term weight maintenance in overweight children. Thus, new concepts are needed to improve long-term treatment success in patients with lower success rates.
authors.affiliation: Department of Pediatric Endocrinology and Diabetology, Charité University Medicine, Berlin, Germany.
authors.forename: Susanna
authors.initials: S
authors.lastname: Wiegand
authors.forename: Klaus-Michael
authors.initials: KM
authors.lastname: Keller
authors.forename: Thomas
authors.initials: T
authors.lastname: Lob-Corzilius
authors.forename: Wilfried
authors.initials: W
authors.lastname: Pott
authors.forename: Thomas
authors.initials: T
authors.lastname: Reinehr
authors.forename: Markus
authors.initials: M
authors.lastname: Röbl
authors.forename: Rainer
authors.initials: R
authors.lastname: Stachow
authors.forename: Sabine
authors.initials: S
authors.lastname: Tuschy
authors.forename: Ingo
authors.initials: I
authors.lastname: Weidanz
authors.forename: Kurt
authors.initials: K
authors.lastname: Widhalm
authors.forename: Martina
authors.initials: M
authors.lastname: de Zwaan
authors.forename: Reinhard W
authors.initials: RW
authors.lastname: Holl
mesh_terms: D000293:Adolescent; D000328:Adult; D001835:Body Weight / Q000502:physiology; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D050177:Overweight / Q000175:diagnosis* / Q000453:epidemiology; D063766:Pediatric Obesity / Q000175:diagnosis* / Q000453:epidemiology; D011379:Prognosis; D012189:Retrospective Studies; D012959:Socioeconomic Factors; D015431:Weight Loss; D055815:Young Adult