Effectiveness of a Family-Centered Pediatric Weight Management Program Integrated in Primary Care

Abstract

Introduction: The evidence supporting the effectiveness of weight loss interventions with low to medium intensity is limited.

Objective: To measure the effectiveness of a family-based weight management intervention in pediatric primary care to reduce body weight in children.

Methods: Electronic medical record data of pediatric patients in Kaiser Permanente Orange County, California, who were enrolled in weight management between April 2014 and December 2018 (family-based behavior-changing weight management [FB-WMG], n = 162) and compared with a control group (CG) of patients who were referred but did not enroll (Ref-CG, n = 203) and an area-matched CG also matched by sex, age, zip code, and body mass index (BMI) (Area-CG, n = 287). BMI was measured at the first visit (or index date) and after 6 months.

Results: Children enrolled in the FB-WMG had 5 (interquartile range = 3-6) sessions over the first 6 months of the program. Most FB-WMG patients (69.1%) reduced or maintained BMI over 6 months, compared with 45.8% of Ref-CG (p < 0.001) and 57.8% of Area-CG (p = 0.02). In girls 3 to 12 years of age, 75% of participants reduced or maintained BMI, compared with 42% of Ref-CG (p < 0.001) and 59.8% of Area-CG (p = 0.07). On average, the difference in BMI change over the 6-month follow-up period was -0.85 kg/m² (95% confidence interval = -1.25 to -0.46 kg/m²) compared with Ref-CG and -0.28 kg/m² (95% confidence interval = -0.63 to 0.08 kg/m²) and Area-CG.

Conclusion: Low- to moderate-intensity family-based weight management intervention in primary care can be successful after only 6 months compared with a referred control group.

Figure 1.

Study flowchart.

Figure 2.

Odds ratio of reducing or maintaining BMI at 6 months after baseline for the family-based weight management intervention group (FB-WMG) compared with eligible and referred controls (Ref-CG, A) and area-matched controls (Area-CG, B).

Figure 3.

Difference in differences (DID) in BMI at 6 months after baseline for the family-based weight management intervention group (FB-WMG) compared with eligible and referred controls who never participated (Ref-CG, A) and matched area controls (Area-CG, B).