Family-based obesity treatment in children with disabilities.
OBJECTIVE
To assess the relative effectiveness of an interdisciplinary, family-centered, tertiary-care pediatric weight management program for the treatment of patients with and without cognitive disabilities (CD).


METHODS
Retrospective analysis of the clinical database of a tertiary-care pediatric weight management clinic (n = 453), extracting data from electronic health records including longitudinal change in weight status (body mass index [BMI] z-score) and frequency of attrition from treatment. Upon review of medical records, children enrolled in the treatment program were classified as having no CD (n = 342) or CD (n = 111).


RESULTS
At baseline, there were no between-group differences in BMI or BMI z-score. After 4 months of treatment, 66% (299) of patients remained enrolled, and complete case data were available for 219 children in final analyses. There were no statistically significant differences in attrition between the 2 groups (no CD vs CD). Mean change in BMI z-score across all groups was -0.03 ± 0.13 (P < .001). Change in BMI z-score was significantly greater among patients with CD (-0.07 ± 0.15) compared to those without CD (-0.03 ± 0.12) (difference 0.04, 95% confidence interval 0.005-0.08, P = .029). These change estimates were observed after adjusting for processes potentially associated with attrition.


CONCLUSIONS
Children with CD treated in an interdisciplinary, family-centered obesity clinic had similar or better outcomes compared to peers without CD. This success may be attributable to the patient-centered nature of this behavioral weight management program, which focused on leveraging the unique strengths and capabilities of each individual patient and family.
Department of Pediatrics, Wake Forest School of Medicine, Winston-Salem, NC.
Callie L
CL
Brown
Department of Pediatrics, Wake Forest School of Medicine, Winston-Salem, NC; Brenner FIT Program, Brenner Children's Hospital, Winston-Salem, NC.
Megan B
MB
Irby
Department of Anesthesia, Wake Forest School of Medicine, Winston-Salem, NC.
Timothy T
TT
Houle
Department of Pediatrics, Wake Forest School of Medicine, Winston-Salem, NC; Division of Public Health Sciences, Department of Epidemiology and Prevention Wake Forest School of Medicine, Winston-Salem, NC; Brenner FIT Program, Brenner Children's Hospital, Winston-Salem, NC. Electronic address: jskelton@wakehealth.edu.
Joseph A
JA
Skelton
D000293:Adolescent; D001289:Attention Deficit Disorder with Hyperactivity / Q000150:complications; D001308:Auditory Perceptual Disorders / Q000150:complications; D000067877:Autism Spectrum Disorder / Q000150:complications; D015992:Body Mass Index; D016022:Case-Control Studies; D002547:Cerebral Palsy / Q000150:complications; D002648:Child; D016208:Databases, Factual; D019988:Children with Disabilities; D004314:Down Syndrome / Q000150:complications; D005081:Exercise Therapy; D005196:Family Therapy; D005247:Feeding Behavior; D005260:Female; D006801:Humans; D008607:Intellectual Disability / Q000150:complications; D007859:Learning Disabilities / Q000150:complications; D008137:Longitudinal Studies; D008297:Male; D010348:Patient Care Team; D063766:Pediatric Obesity / Q000150:complications / Q000628:therapy*; D012189:Retrospective Studies; D016896:Treatment Outcome; D018980:Williams Syndrome / Q000150:complications
childhood; disabilities; obesity; treatment