A clinical model of obesity treatment is more effective in preschoolers and Spanish speaking families

Abstract

Objective: Preschool and minority children have not been well represented in obesity treatment studies. This analysis of clinical obesity treatment was carried out within a diverse population of children 2-12 years to identify demographic characteristics associated with successful treatment.

Design and methods: A medical record review captured BMI and demographics for children 2-12 years who began treatment during a 42-month period (n = 479). Associations of body mass index z-score (BMI-Z) change with child and family demographics were examined with logistic regression and time-to-event analysis.

Results: Treatment led to a mean BMI-Z decrease of 0.18. Half of children with follow-up (n = 273) exceeded the a priori cut-off for successful treatment of -0.1 BMI-Z. Preschoolers and children of Spanish-speakers were more likely to succeed, (Adjusted OR: 5.8 [95% CI: 2.7-12.2] and 2.3 [95% CI: 1.1, 4.9]). The hazard ratio for treatment failure was 3.7 [95% CI: 2.1, 6.8] for children starting treatment at 6-12 years compared to preschoolers, adjusted for other demographics.

Conclusions: This mode of treatment was more likely to succeed among children treated before school age and among children whose parents spoke only Spanish. Screening and treatment for obesity in preschoolers and Hispanic immigrant families deserve further prospective study.

FIGURE 1

Children with at least one follow-up visit included, n=265. Censoring occurred if BMI-Z was decreased at least −0.1 at last captured follow-up visit. Upper stratum in red: 2–5 years at start of GLC treatment. Lower stratum in blue: 6–12 yrs at start of treatment. Survival Distribution Function: proportion of each strata with a BMI-Z decrease of at least −0.10.