Who benefits most from outpatient lifestyle intervention? An IMI-SOPHIA study on pediatric individuals living with overweight and obesity.
Journal
Obesity (Silver Spring, Md.)
ISSN: 1930-739X
Titre abrégé: Obesity (Silver Spring)
Pays: United States
ID NLM: 101264860
Informations de publication
Date de publication:
09 2023
09 2023
Historique:
revised:
24
05
2023
received:
29
03
2023
accepted:
30
05
2023
medline:
23
8
2023
pubmed:
7
8
2023
entrez:
7
8
2023
Statut:
ppublish
Résumé
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. 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. 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). These results support the importance of patient-tailored intervention and earlier treatment escalation in high-risk individuals who have little chance of success.
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
2375-2385Informations de copyright
© 2023 The Authors. Obesity published by Wiley Periodicals LLC on behalf of The Obesity Society.
Références
Farpour-Lambert NJ, Baker JL, Hassapidou M, et al. Childhood obesity is a chronic disease demanding specific health care-a position statement from the Childhood Obesity Task Force (COTF) of the European Association for the Study of Obesity (EASO). Obes Facts. 2015;8(5):342-349.
Schienkiewitz A, Brettschneider AK, Damerow S, Rosario AS. Overweight and obesity among children and adolescents in Germany. Results of the cross-sectional KiGGS Wave 2 study and trends. Article in German. J Health Monit. 2018;3(1):16-23.
Woolford SJ, Sidell M, Li X, et al. Changes in body mass index among children and adolescents during the COVID-19 pandemic. JAMA. 2021;326(14):1434-1436.
Vogel M, Geserick M, Gausche R, et al. Age- and weight group-specific weight gain patterns in children and adolescents during the 15 years before and during the COVID-19 pandemic. Int J Obes (Lond). 2022;46(1):144-152.
Reinehr T. Effectiveness of lifestyle intervention in overweight children. Proc Nutr Soc. 2011;70(4):494-505.
Wabitsch M, Moß A. Evidenzbasierte (S3-) Leitlinie der Arbeitsgemeinschaft Adipositas im Kindes- und Jugendalter (AGA) der Deutschen Adipositas-Gesellschaft (DAG) und der Deutschen Gesellschaft für Kinder- und Jugendmedizin (DGKJ). Therapie und Prävention der Adipositas im Kindes- und Jugendalter. In German. Published August 2019. https://register.awmf.org/de/leitlinien/detail/050-002
Bohn B, Stachow R, Gellhaus I, Matthias J, Lichtenstern H, Holl RW. Heterogeneity in sociodemographic characteristics and cardiovascular risk factors at the initiation of a lifestyle intervention for obesity within Germany: an APV multicenter study on 40,942 children and adolescents. Child Adolesc Obes. 2018;1(1):5-17.
Kromeyer-Hauschild K, Moss A, Wabitsch M. Body mass index reference values for German children, adolescents and adults. Adipositas. 2015;9(3):123-127.
Cole TJ, Bellizzi MC, Flegal KM, Dietz WH. Establishing a standard definition for child overweight and obesity worldwide: international survey. BMJ. 2000;320(7244):1240-1243.
Wiegand S, Keller KM, Lob-Corzilius T, et al. Predicting weight loss and maintenance in overweight/obese pediatric patients. Horm Res Paediatr. 2014;82(6):380-387.
Kroll LE, Schumann M, Hoebel J, Lampert T. Regional health differences - developing a socioeconomic deprivation index for Germany. J Health Monit. 2017;2(2):98-114.
Neuhauser HK, Thamm M, Ellert U, Hense HW, Rosario AS. Blood pressure percentiles by age and height from nonoverweight children and adolescents in Germany. Pediatrics. 2011;127(4):978-988.
Chourdakis M, Buderus S, Dokoupil K, et al. S2k-Leitlinien zur Diagnostik und Therapie von Hyperlipidämien bei Kindern und Jugendlichen. In German. Published April 2015. https://register.awmf.org/de/leitlinien/detail/027-068
World Health Organization & International Diabetes Federation. Definition and Diagnosis of Diabetes Mellitus and Intermediate Hyperglycemia: Report of a WHO/IDF Consultation. WHO; 2006.
American Diabetes Association. Diagnosis and classification of diabetes mellitus. Diabetes Care. 2011;34(suppl 1):S62-S69.
Genolini C, Falissard B. KmL: K-means for longitudinal data. Comput Stat. 2010;25(2):317-328.
Genolini C, Falissard B. KmL: a package to cluster longitudinal data. Comput Methods Programs Biomed. 2011;104(3):112-121.
Caliński T, Harabasz J. A dendrite method for cluster analysis. Commun Stat. 1974;3(1):1-27.
Ray S, Turi R. Determination of number of clusters in K-means clustering and application in colour image segmentation. In: Pal NR, De AK, Das J, eds. Proceedings of the 4th International Conference on Advances in Pattern Recognition and Digital Techniques. Narosa Publishing House; 1999:137-143.
Nagin DS. Group-Based Modeling of Development. Harvard University Press; 2005.
Jones BL. Traj: group-based modeling of longitudinal data. Accessed December 14, 2022. http://www.andrew.cmu.edu/user/bjones/index.htm
van de Pas KGH, Lubrecht JW, Hesselink ML, Winkens B, van Dielen FMH, Vreugdenhil ACE. The effect of a multidisciplinary lifestyle intervention on health parameters in children versus adolescents with severe obesity. Nutrients. 2022;14(9):1795. doi:10.3390/nu14091795
Reinehr T, Wabitsch M, Andler W, et al; APV Study Group. Medical care of obese children and adolescents. Eur J Pediatr. 2004;163(6):308-312.
Jørgensen RM, Bruun JM, Kremke B, Bahnsen RF, Nielsen BW, Vestergaard ET. Sustainable weight loss over three years in children with obesity: a pragmatic family-centered lifestyle intervention. Eat Weight Disord. 2021;26(2):537-545.
Mead E, Brown T, Rees K, et al. Diet, physical activity and behavioural interventions for the treatment of overweight or obese children from the age of 6 to 11 years. Cochrane Database Syst Rev. 2017;2017:CD012651. doi:10.1002/14651858.CD012651
Al-Khudairy L, Loveman E, Colquitt JL, et al. Diet, physical activity and behavioural interventions for the treatment of overweight or obese adolescents aged 12 to 17 years. Cochrane Database Syst Rev. 2017;6(6):CD012691. doi:10.1002/14651858.CD012691
Weihrauch-Blüher S, Wiegand S, Weihe P, et al; APV Study Group. Uric acid and gamma-glutamyl-transferase in children and adolescents with obesity: association to anthropometric measures and cardiometabolic risk markers depending on pubertal stage, sex, degree of weight loss and type of patient care: evaluation of the adiposity patient follow-up registry. Pediatr Obes. 2023;18(3):e12989. doi:10.1111/ijpo.12989
Reinehr T, Widhalm K, l'Allemand D, Wiegand S, Wabitsch M, Holl RW; APV-Wiss STudy Group and German Competence Net Obesity. Two-year follow-up in 21,784 overweight children and adolescents with lifestyle intervention. Obesity (Silver Spring). 2009;17(6):1196-1199.
Hoffmeister U, Bullinger M, van Egmond-Fröhlich A, et al. Overweight and obesity in childhood and adolescence. Evaluation of inpatient and outpatient care in Germany: the EvAKuJ study. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2011;54(1):128-135.
Bondyra-Wiśniewska B, Myszkowska-Ryciak J, Harton A. Impact of lifestyle intervention programs for children and adolescents with overweight or obesity on body weight and selected cardiometabolic factors-a systematic review. Int J Environ Res Public Health. 2021;18(4):2061. doi:10.3390/ijerph18042061
Jørgensen RM, Vestergaard ET, Kremke B, Bahnsen RF, Nielsen BW, Bruun JM. The association between weight loss and long term development in quality-of-life among children living with obesity: a pragmatic descriptive intervention study. Ital J Pediatr. 2022;48(1):135. doi:10.1186/s13052-022-01326-2
Weghuber D, Barrett T, Barrientos-Pérez M, et al; STEP TEENS Investigators. Once-weekly semaglutide in adolescents with obesity. N Engl J Med. 2022;387(24):2245-2257.
European Medicines Agency. Saxenda: Summary of product characteristics. Accessed March 27, 2023. https://www.ema.europa.eu/en/documents/product-information/saxenda-epar-product-information_en.pdf.
Ning Y, Yang S, Evans RK, et al. Changes in body anthropometry and composition in obese adolescents in a lifestyle intervention program. Eur J Nutr. 2014;53(4):1093-1102.
Böhler T, Goldapp C, Mann R, et al. Sensitivity analysis of weight reduction results of an observational cohort study in overweight and obese children and adolescents in Germany: the EvAKuJ study. Pediatr Rep. 2013;5(3):e16. doi:10.4081/pr.2013.e16
Reinehr T, Kleber M, Lass N, Toschke AM. Body mass index patterns over 5 y in obese children motivated to participate in a 1-y lifestyle intervention: age as a predictor of long-term success. Am J Clin Nutr. 2010;91(5):1165-1171.
Oude Luttikhuis H, Baur L, Jansen H, et al. Interventions for treating obesity in children. Cochrane Database Syst Rev. 2009;1:CD001872.
Rancourt D, Jensen CD, Duraccio KM, Evans EW, Wing RR, Jelalian E. Successful weight loss initiation and maintenance among adolescents with overweight and obesity: does age matter? Clin Obes. 2018;8(3):176-183.
Robinson TN, Matheson D, Wilson DM, et al. A community-based, multi-level, multi-setting, multi-component intervention to reduce weight gain among low socioeconomic status Latinx children with overweight or obesity: the Stanford GOALS randomised controlled trial. Lancet Diabetes Endocrinol. 2021;9(6):336-349.
Arayess L, Knockaert N, Winkens B, Lubrecht JW, Verweij M, Vreugdenhil ACE. The side-effects of the COVID-19 pandemic: increased BMI z-score in children with overweight and obesity in a personalised lifestyle intervention one year after the start of the pandemic in The Netherlands. Nutrients. 2022;14(9):1942. doi:10.3390/nu14091942
Koning M, Hoekstra T, de Jong E, Visscher TLS, Seidell JC, Renders CM. Identifying developmental trajectories of body mass index in childhood using latent class growth (mixture) modelling: associations with dietary, sedentary and physical activity behaviors: a longitudinal study. BMC Public Health. 2016;16(1):1128. doi:10.1186/s12889-016-3757-7
Greenway FL. Physiological adaptations to weight loss and factors favouring weight regain. Int J Obes (Lond). 2015;39(8):1188-1196.
Hollensted M, Fogh M, Schnurr TM, et al. Genetic susceptibility for childhood BMI has no impact on weight loss following lifestyle intervention in Danish children. Obesity (Silver Spring). 2018;26(12):1915-1922.
Heitkamp M, Siegrist M, Molnos S, et al. Obesity genes and weight loss during lifestyle intervention in children with obesity. JAMA Pediatr. 2021;175(1):e205142. doi:10.1001/jamapediatrics.2020.5142
Vallis M, Boyland E, Caroli M, et al. Adherence to treatment recommendations in chronic disease: what is (im)possible? Expert conclusions from the 30th ECOG workshop 2021. Ann Nutr Metab. 2022;78(6):352-358.