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Purpose: Multidisciplinary weight management (MDM) signi cantly improves outcomes in youth, when compared to their routine care. However, this progress may be undermined by high follow-up attrition. We hypothesized that a pre-de ned time-limited MDM clinic follow-up plan given to families from the "get-go" will improve individual clinic participation, weight, and metabolic parameters.Methods: Participant follow-up rates in 7 consecutive visits in a retrospective cohort of youth followed at an urban MDM clinic between April 2017 to September 2019 after the clinic follow-up protocol was changed (Post-PC) were compared to our previously published data (Pre-PC, December 2014 to January 2017). Secondary outcomes include changes (Δ) in body mass index z-score (z-BMI), body composition analysis (BCA), and laboratory parameters.Results: 615 records (12.3 + 3.7 years, 46% male) were reviewed. Participants' follow up rates improved signi cantly starting visit 3 (Post-PC (49.2%) vs. Pre-PC (40.2%); p=0.03). With continued MDM participation, mean z-BMI Δ progressively improved. BCA Δ included a mean total body fat mass (FM) decrease (-2.07+7.3 kg) along with total body muscle mass (MM) increase (3.3+5.6 kg). Signi cant improvements were noted with hemoglobin A1c %, total cholesterol (TC), triglyceride, AST, and ALT concentrations. FM Δ correlated signi cantly with glucose and HOMA-IR Δ, while MM Δ was inversely associated with TC and LDL-cholesterol Δ.Conclusion: A protocolized MDM follow plan resulted in a small but signi cant improvement in the participants' follow-up along with signi cant improvements in weight and metabolic outcomes. Further improvements will likely require additional behavioral economic strategies.

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