title: Characteristics of Youth Presenting for Weight Management: Retrospective National Data from the POWER Study Group.
abstract: BACKGROUND
  There are no existing multisite national data on obese youth presenting for pediatric weight management. The primary aim was to describe BMI status and comorbidities among youth with obesity presenting for pediatric weight management (PWM) at programs within the Pediatric Obesity Weight Evaluation Registry (POWER).
  
  
  METHODS
  Data were collected from 2009-2010 among 6737 obese patients ages 2-17. Patients were classified in three groups by BMI (kg/m(2)) cutoffs and percent of the 95th percentile for BMI: (1) obesity; (2) severe obesity class 2; and (3) severe obesity class 3. Weighted percentages are presented for baseline laboratory tests, blood pressure, and demographics. Generalized logistic regression with clustering was used to examine the relationships between BMI status and comorbidities.
  
  
  RESULTS
  Study youth were 11.6 ± 3.4 years of age, 56% female, 31% black, 17% Hispanic, and 53% publicly insured. Twenty-five percent of patients had obesity (n = 1674), 34% (2337) had severe obesity class 2, and 41% (2726) had severe obesity class 3. Logistic regression revealed that males (odds ratio [OR], 1.8; 95% confidence interval [CI], 1.5-2.0), blacks (OR, 1.7; 95% CI, 1.5-2.0), age <6 years (OR, 2.0; 95% CI, 1.5-2.6), and public insurance (OR, 1.8; 95% CI, 1.5-2.0) had a higher odds of severe obesity class 3. Severe obesity class 3 was associated with higher odds of laboratory abnormalities for hemoglobin A1c (OR, 1.7; 95% CI, 1.3-2.2), alanine aminotransferase ≥40 U/L (OR, 1.9; 95% CI, 1.3-2.6), and elevated systolic blood pressure (OR, 2.5; 95% CI, 2.0-3.0).
  
  
  CONCLUSIONS
  Youth with obesity need earlier access to PWM given that they are presenting when they have severe obesity with significant comorbidities.
authors.affiliation: 1 UCSF Benioff Children's Hospitals , Oakland, CA.
authors.forename: Carolyn Bradner
authors.initials: CB
authors.lastname: Jasik
authors.affiliation: 2 Cincinnati Children's Hospital , Cincinnati, OH.
authors.forename: Eileen C
authors.initials: EC
authors.lastname: King
authors.affiliation: 3 Boston Children's Hospital , Boston, MA.
authors.forename: Erinn
authors.initials: E
authors.lastname: Rhodes
authors.affiliation: 4 Children's Mercy Hospitals and Clinics , Kansas City, MO.
authors.forename: Brooke
authors.initials: B
authors.lastname: Sweeney
authors.affiliation: 5 Children's National Health System , Washington, DC.
authors.forename: Michele
authors.initials: M
authors.lastname: Mietus-Snyder
authors.affiliation: 6 Seattle Children's Hospital , Seattle, WA.
authors.forename: H Mollie
authors.initials: HM
authors.lastname: Grow
authors.affiliation: 7 Children's Hospital Association , Washington, DC.
authors.forename: J Mitchell
authors.initials: JM
authors.lastname: Harris
authors.affiliation: 7 Children's Hospital Association , Washington, DC.
authors.forename: Lynne
authors.initials: L
authors.lastname: Lostocco
authors.affiliation: 8 North Carolina Children's Hospital , Chapel Hill, NC.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Estrada
authors.affiliation: 9 Connecticut Children's Medical Center , Hartford, CT.
authors.forename: Katie
authors.initials: K
authors.lastname: Boyle
authors.affiliation: 10 Helen DeVos Children's Hospital , Grand Rapids, MI.
authors.forename: Jared M
authors.initials: JM
authors.lastname: Tucker
authors.affiliation: 11 Nationwide Children's Hospital , Columbus, OH.
authors.forename: Ihuoma U
authors.initials: IU
authors.lastname: Eneli
authors.affiliation: 12 C.S. Mott Children's Hospital , Ann Arbor, MI.
authors.forename: Susan J
authors.initials: SJ
authors.lastname: Woolford
authors.affiliation: 13 Nemours/Alfred I. duPont Hospital for Children , Wilmington, DE.
authors.forename: George
authors.initials: G
authors.lastname: Datto
authors.affiliation: 10 Helen DeVos Children's Hospital , Grand Rapids, MI.
authors.forename: William
authors.initials: W
authors.lastname: Stratbucker
authors.affiliation: 2 Cincinnati Children's Hospital , Cincinnati, OH.
authors.forename: Shelley
authors.initials: S
authors.lastname: Kirk
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D037001:Directive Counseling / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D063766:Pediatric Obesity / Q000453:epidemiology / Q000517:prevention & control*; D017410:Practice Guidelines as Topic; D011320:Primary Health Care / Q000458:organization & administration*; D012017:Referral and Consultation / Q000458:organization & administration*; D012042:Registries; D012189:Retrospective Studies; D012307:Risk Factors; D014481:United States / Q000453:epidemiology