A pediatric weight management program for high-risk populations: a preliminary analysis.

Abstract

To determine whether a multidisciplinary pediatric weight management program effectively improves BMI, BMI z-score, and cardiovascular risk factors (CVRFs) in high-risk populations. A retrospective chart review was performed on children seen in the NEW Kids Program at the Children's Hospital of Wisconsin, a family-based clinic that treats pediatric obesity using medical management, nutrition education, behavioral intervention, and physical activity. Inclusion criteria were program participation for >or=9 months and >4 visits. Analyses were performed to identify factors associated with pre- to postintervention changes in BMI, BMI z-score, and CVRF laboratory values. A total of 66 patients met inclusion criteria; the mean age was 11 years (s.d.+/-3.4), 56% were racial/ethnic minorities, 45% were Medicaid recipients, 48% resided in impoverished communities, and 38% had a BMI >or=40 kg/m(2). Of the 66 patients, 91% had more than one weight-related comorbidity, 88% had CVRFs, and the preintervention mean BMI was 37 kg/m(2). After the intervention, there was an overall increase in absolute BMI, but a small, yet significant decrease in BMI z-score (mean -0.03+/-0.16; P<0.05). There were significant pregroup to postgroup improvements in total cholesterol, low-density lipoprotein, and triglycerides levels (P<0.05). Insurance coverage, race/ethnicity, gender, age, and initial BMI were not significantly associated with changes in BMI or BMI z-score. A multidisciplinary pediatric weight management program can improve the weight status of high-risk populations, including minorities, Medicaid recipients, patients with multiple comorbidities and CVRFs, and the severely obese.