Skip to main content

Lund University Publications

LUND UNIVERSITY LIBRARIES

Who benefits most from outpatient lifestyle intervention? An IMI-SOPHIA study on pediatric individuals living with overweight and obesity

Prinz, Nicole ; Pomares-Millan, Hugo LU orcid ; Dannemann, Almut ; Giordano, Giuseppe N. LU ; Joisten, Christine ; Körner, Antje ; Weghuber, Daniel ; Weihrauch-Blüher, Susann ; Wiegand, Susanna and Holl, Reinhard W. , et al. (2023) In Obesity 31(9). p.2375-2385
Abstract

Objective: The first-line approach for childhood obesity is lifestyle intervention (LI); however, success varies. This study aimed first to identify distinct subgroups of response in children living with overweight and obesity and second to elucidate predictors for subclusters. Methods: Based on the obesity patient follow-up registry the APV (Adipositas-Patienten-Verlaufsdokumentation) initiative, a total of 12,453 children and adolescents (median age: 11.5 [IQR: 9.7–13.2] years; BMI z score [BMIz]: 2.06 [IQR: 1.79–2.34]; 52.6% girls) living with overweight/obesity and participating in outpatient LI were studied. Longitudinal k-means clustering was used to identify individual BMIz response curve for up to 2 years after treatment... (More)

Objective: The first-line approach for childhood obesity is lifestyle intervention (LI); however, success varies. This study aimed first to identify distinct subgroups of response in children living with overweight and obesity and second to elucidate predictors for subclusters. Methods: Based on the obesity patient follow-up registry the APV (Adipositas-Patienten-Verlaufsdokumentation) initiative, a total of 12,453 children and adolescents (median age: 11.5 [IQR: 9.7–13.2] years; BMI z score [BMIz]: 2.06 [IQR: 1.79–2.34]; 52.6% girls) living with overweight/obesity and participating in outpatient LI were studied. Longitudinal k-means clustering was used to identify individual BMIz response curve for up to 2 years after treatment initiation. Multinomial logistic regression was used to elucidate predictors for cluster membership. Results: A total of 36.3% of children and adolescents experienced “no BMIz loss.” The largest subcluster (44.8%) achieved “moderate BMIz loss,” with an average delta-BMIz of −0.23 (IQR: −0.33 to −0.14) at study end. A total of 18.9% had a “pronounced BMIz loss” up to −0.61 (IQR: −0.76 to −0.49). Younger age and lower BMIz at LI initiation, larger initial BMIz loss, and less social deprivation were linked with higher likelihood for moderate or pronounced BMIz loss compared with the no BMIz loss cluster (all p < 0.05). Conclusions: These results support the importance of patient-tailored intervention and earlier treatment escalation in high-risk individuals who have little chance of success.

(Less)
Please use this url to cite or link to this publication:
author
; ; ; ; ; ; ; ; and , et al. (More)
; ; ; ; ; ; ; ; ; and (Less)
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Obesity
volume
31
issue
9
pages
11 pages
publisher
Nature Publishing Group
external identifiers
  • pmid:37545199
  • scopus:85167366929
ISSN
1930-7381
DOI
10.1002/oby.23844
language
English
LU publication?
yes
id
4b17e4d1-aa47-4f7d-91d1-dcf7a2c5a103
date added to LUP
2023-10-30 12:13:06
date last changed
2024-04-19 03:01:52
@article{4b17e4d1-aa47-4f7d-91d1-dcf7a2c5a103,
  abstract     = {{<p>Objective: The first-line approach for childhood obesity is lifestyle intervention (LI); however, success varies. This study aimed first to identify distinct subgroups of response in children living with overweight and obesity and second to elucidate predictors for subclusters. Methods: Based on the obesity patient follow-up registry the APV (Adipositas-Patienten-Verlaufsdokumentation) initiative, a total of 12,453 children and adolescents (median age: 11.5 [IQR: 9.7–13.2] years; BMI z score [BMIz]: 2.06 [IQR: 1.79–2.34]; 52.6% girls) living with overweight/obesity and participating in outpatient LI were studied. Longitudinal k-means clustering was used to identify individual BMIz response curve for up to 2 years after treatment initiation. Multinomial logistic regression was used to elucidate predictors for cluster membership. Results: A total of 36.3% of children and adolescents experienced “no BMIz loss.” The largest subcluster (44.8%) achieved “moderate BMIz loss,” with an average delta-BMIz of −0.23 (IQR: −0.33 to −0.14) at study end. A total of 18.9% had a “pronounced BMIz loss” up to −0.61 (IQR: −0.76 to −0.49). Younger age and lower BMIz at LI initiation, larger initial BMIz loss, and less social deprivation were linked with higher likelihood for moderate or pronounced BMIz loss compared with the no BMIz loss cluster (all p &lt; 0.05). Conclusions: These results support the importance of patient-tailored intervention and earlier treatment escalation in high-risk individuals who have little chance of success.</p>}},
  author       = {{Prinz, Nicole and Pomares-Millan, Hugo and Dannemann, Almut and Giordano, Giuseppe N. and Joisten, Christine and Körner, Antje and Weghuber, Daniel and Weihrauch-Blüher, Susann and Wiegand, Susanna and Holl, Reinhard W. and Lanzinger, Stefanie}},
  issn         = {{1930-7381}},
  language     = {{eng}},
  number       = {{9}},
  pages        = {{2375--2385}},
  publisher    = {{Nature Publishing Group}},
  series       = {{Obesity}},
  title        = {{Who benefits most from outpatient lifestyle intervention? An IMI-SOPHIA study on pediatric individuals living with overweight and obesity}},
  url          = {{http://dx.doi.org/10.1002/oby.23844}},
  doi          = {{10.1002/oby.23844}},
  volume       = {{31}},
  year         = {{2023}},
}