Attenuated efficacy of pediatric obesity treatment during the COVID‐19 pandemic

Appelhans, Bradley M.; French, Simone A.; Martin, Molly A.; Lui, Karen; Janssen, İmke

doi:10.1002/oby.23313

Cited by 22 publications

(15 citation statements)

References 24 publications

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“…Accelerated weight gain could not be prevented in children who participated <1 year in our lifestyle intervention. These results are in agreement with outcomes of Appelhans et al [23] who reported an increase in the BMI z-score in children with overweight and obesity measured 6 and 12 months after participation in a lifestyle intervention during the COVID-19 pandemic. Although weight gain might be reduced or other positive effects of the guiding of children and families might be present, shortterm lifestyle intervention seems to be insufficient to halt accelerated weight gain during the COVID-19 pandemic.…”

Section: Discussionsupporting

confidence: 92%

“…Lifestyle intervention is the treatment of choice in children with overweight and obesity, resulting in significant weight loss and improvement of cardiovascular parameters [ 20 , 21 ]. However, the recent literature indicates that treatment efficacy of pediatric obesity programs provided during the pandemic is markedly reduced [ 23 ]. The effect of participating in lifestyle intervention prior to the pandemic on weight gain during the pandemic, and possible protective effects, has not yet been investigated.…”

Section: Introductionmentioning

confidence: 99%

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Weight Gain in Children during the COVID-19 Pandemic and the Protective Effect of Lifestyle Intervention in Children with Obesity

et al. 2022

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Introduction: School closures due to the COVID-19 pandemic affect children’s daily structure, mealtimes, physical activity and sleeping habits, possibly exacerbating weight gain, particularly in vulnerable children with overweight and obesity. This study aims to evaluate both perceived and objectively measured weight gain in children in the Netherlands during the COVID-19 pandemic and the effect of prior lifestyle intervention. Methods: 150 children of the Children, Obesity and Lifestyle during COVID-19 (COLC) study (cohort A) reported perceptions of weight change during the COVID-19 pandemic. Anthropometric data of 65 children with overweight and obesity was collected at the expertise Centre for Overweight Adolescent and Children’s Healthcare in the same period (COACH; cohort B). Results: In cohort A, 43% of children with overweight and obesity perceived weight gain during the pandemic, compared to 15% of lean children. In cohort B, BMI z-score increased significantly (+0.065 SD) within five months. Participation in a lifestyle intervention for >1 year and having parents with Dutch background was associated with less weight gain, specifically in children with obesity. Discussion/Conclusion: In particular children with overweight and obesity seem to be at risk for accelerated weight gain during the COVID-19 pandemic. Prior long-term participation in a lifestyle intervention protects against this weight gain, which emphasizes the importance of strong support for vulnerable populations during health crises and pleads for wide implementation of lifestyle interventions for children.

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Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

Weight Gain in Children during the COVID-19 Pandemic and the Protective Effect of Lifestyle Intervention in Children with Obesity

et al. 2022

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“…Among these subjects, approximately 60% reported an increase in body weight, which was significantly greater in adolescents than in children (13). Consistently, Appelhans et al demonstrated a significant weight gain among low-income, racial minority, obese children followed during the Covid-19 period compared to those followed in the pre-pandemic period at 12-month assessment (14).…”

Section: Discussionmentioning

confidence: 74%

“…Consistently, Appelhans et al. demonstrated a significant weight gain among low-income, racial minority, obese children followed during the Covid-19 period compared to those followed in the pre-pandemic period at 12-month assessment ( 14 ).…”

Section: Discussionmentioning

confidence: 87%

Impact of Covid-19 Pandemic on the Effectiveness of Outpatient Counseling in Childhood Obesity Management

et al. 2022

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The Covid-19 pandemic drastically modified social life and lifestyle, in particular, among children and adolescents, promoting sedentary behaviors and unhealthy eating habits. The aims of this study were to assess the rate and the factors associated with outpatient drop-out in childhood obesity management, and to evaluate how the Covid-19 pandemic influenced weight status and lifestyle of children and adolescents with obesity. One hundred and forty-five children and adolescents with obesity were identified, including 80 subjects evaluated before the Covid-19 pandemic (group A) and 65 subjects in the period straddling the Covid-19 pandemic (group B). Anamnestic (family history of obesity, dietary habits, physical activity, screen time), socio-cultural (economic status, employment and schooling of parents, household composition, place of living) and clinical (weight, height, BMI, waist circumference) data were retrospectively analyzed for each subject in both groups at baseline (V0) and 12-months (V1) at in-person assessment. Glycemic and lipid profiles were assessed at V0. Drop-out rate did not differ significantly between the two groups. BMI SDS at V0 (OR=2.52; p=0.004), female sex (OR=0.41; p=0.035), and the presence of a single parent in the household (OR=5.74; p=0.033) significantly influenced drop-out in both groups. Weight loss between V0 and V1 was significantly greater among group A patients compared to group B (p=0.031). In group B, hours spent in physical activity significantly decreased from V0 to V1, being significantly lower than group A at V1; on the contrary, screen time significantly increased in the same period. The consumption of sugary drinks and snacks was significantly greater in group B than group A at V1. Our study documented that the Covid-19 pandemic, although not affecting the drop-out rate of obese children in a follow-up program, negatively influenced lifestyle and reduced the effectiveness of outpatient counseling in childhood obesity treatment.

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“…Although the transition of pediatric weight management interventions (PWMIs) to telehealth following the onset of the pandemic has been shown to be feasible, (11) delivery of these programs has been overall affected. Suspension of school-based interventions and decreased e cacy of PWMIs have been reported; (12,13) other disciplines have had similar experiences given the need for diverting resources to pandemic response. (14) Evidence-based PWMIs are necessary to mitigate the impact of obesity on child health, particularly in communities that are at highest risk.…”

Section: Introductionmentioning

confidence: 99%

Determinants of Adoption of a Pediatric Weight Management Intervention (PWMI): a Qualitative Study

Velez

Gundewar

Persaud

et al. 2022

Preprint

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BackgroundChildhood obesity is highly prevalent in the US and disproportionately impacts communities of color and low-income populations; these disparities have worsened during the COVID-19 pandemic. Adoption of effective pediatric weight management interventions (PWMIs) that have been evaluated among low-income diverse populations is needed. The Healthy Weight Clinic PWMI, a package co-developed by the American Academy of Pediatrics and Massachusetts General Hospital, helps health centers establish multidisciplinary Healthy Weight Clinics based on previous randomized controlled trials which demonstrated effectiveness. We sought to identify the determinants to successful adoption of this PWMI and understand adaptations needed prior to implementation in new sites. MethodsWe interviewed 20 stakeholders, 10 from two health centers in Mississippi where the Healthy Weight Clinic PWMI will be piloted (pre-implementation sites) and 10 from health centers that have previously implemented it (sites in maintenance stages). Separate interview guides informed by the Consolidated Framework for Implementation Research (CFIR) were developed for the pre-implementation sites and those in maintenance stages, including questions related to adaptations of the PWMI in response to the COVID-19 pandemic. Qualitative data analysis was conducted using directed content analysis based on CFIR constructs. Adaptations in response to the pandemic were categorized using Framework for Reporting Adaptations and Modifications-Expanded (FRAME).ResultsIn pre-implementation sites, an inner setting facilitator mentioned was a positive learning climate. Characteristics of individuals that can facilitate adoption include staff willingness to learn, valuing evidence-based care for childhood obesity, and culturally and weight-sensitive staff. In terms of patient needs and resources (outer setting), social drivers of health are barriers to adoption, but creative solutions were suggested to mitigate these. Other facilitators related to the intervention included its multidisciplinary model and adaptability. Similar themes were elicited from sites in maintenance stages; adaptations brought on by the pandemic, such as telehealth visits and content modification to align with distancing guidelines and the effects of social isolation were also described.ConclusionUnderstanding the determinants to adoption of an evidence-based PWMI informs necessary adaptations and implementation strategies required to facilitate nationwide dissemination of PWMIs, with the goal of reaching the populations most at-risk.

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Attenuated efficacy of pediatric obesity treatment during the COVID‐19 pandemic

Cited by 22 publications

References 24 publications

Weight Gain in Children during the COVID-19 Pandemic and the Protective Effect of Lifestyle Intervention in Children with Obesity

Weight Gain in Children during the COVID-19 Pandemic and the Protective Effect of Lifestyle Intervention in Children with Obesity

Impact of Covid-19 Pandemic on the Effectiveness of Outpatient Counseling in Childhood Obesity Management

Determinants of Adoption of a Pediatric Weight Management Intervention (PWMI): a Qualitative Study

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