Expectations for Treatment in Pediatric Weight Management and Relationship to Attrition

Rhodes, Erinn T.; Boles, Richard E.; Chin, Kimberly J.; Christison, Amy L.; Testa, Elizabeth Getzoff; Guion, Kimberly; Hawkins, Mary Jane; Petty, Carter R.; Gaffka, Bethany J.; Santos, Melissa; Shaffer, Laura A.; Tucker, Jared M.; Hampl, Sarah

doi:10.1089/chi.2016.0215

Cited by 34 publications

(30 citation statements)

References 26 publications

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“…It is also important to understand whether FA predicts the likelihood of dropping out of weight management programmes. The attrition rate in our study was high (approximately 30%) but similar to other studies with this patient population (Rhodes et al, 2017;Tompkins, Laurent, & Brock, 2017). However, FA and non-FA participants completed the weight intervention programme at similar rates, which is in consistent with other WL treatment studies (Burmeister et al, 2013;Lent et al, 2014).…”

Section: Discussionsupporting

confidence: 91%

Food addiction and preoperative weight loss achievement in patients seeking bariatric surgery

Pérez

Sánchez‐González

Sánchez

et al. 2018

Euro Eating Disorders Rev

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Introduction Evidence suggests that food addiction (FA) is prevalent among individuals with obesity seeking bariatric surgery (BS), but there is no evidence about whether FA is a predictor of weight loss (WL). We aimed to analyse the prevalence of FA in patients with obesity seeking BS and to examine whether FA could predict WL following dietary intervention before surgery. Method The study included 110 patients with obesity who underwent a dietetic intervention. Assessment included endocrinological variables, a semistructured interview to rule out mental disorders, and Yale Food Addiction Scale version 2.0 (YFAS 2.0). Results In our sample, the prevalence of FA was 26.4%. Those who met YFAS 2.0 criteria showed less WL after dietetic intervention and regain weight during dietary intervention. Conclusions FA appears to be prevalent in obesity. Our findings confirmed a lower WL throughout dietary intervention before surgery in patients who fulfilled baseline criteria for FA. Future interventions should include multidisciplinary intervention to maximize WL before and after BS.

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Section: Discussionsupporting

confidence: 91%

Food addiction and preoperative weight loss achievement in patients seeking bariatric surgery

Pérez

Sánchez‐González

Sánchez

et al. 2018

Euro Eating Disorders Rev

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“…Since family caregivers play a prominent role in these well‐established treatments, seeking the input of caregivers is critical for the effective delivery of behavioural treatment . While most studies have captured caregiver perspectives at treatment initiation , completion or treatment withdrawal , with feedback specific to intervention approaches , barriers to treatment and reasons for attrition , few studies have captured caregiver experiences related to the psychological and social ramifications of having an obese child .…”

Section: Introductionmentioning

confidence: 99%

Walking in the shoes of caregivers of children with obesity: supporting caregivers in paediatric weight management

et al. 2017

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To incorporate the perspectives and experiences of family caregivers of children with obesity, the KidFit Health and Wellness Clinic, a paediatric weight management programme, embedded feedback opportunities into various stages of programme development. Caregivers were eligible to participate if their children had completed initial 4-week group-based pilot programming or were currently receiving treatment in 10 or 12 week group-based programming. Data were collected through feedback session discussions, audio-recorded, transcribed verbatim and analysed thematically. In total, 6 caregivers participated in the pilot group feedback session and 32 caregivers participated in the structured group feedback sessions. Caregivers reported that healthy lifestyle strategies first communicated by clinic staff to children during group sessions provided expert validation and reinforcement when discussing similar messages at home. Caregivers reported feeling isolated and blamed for causing their children's obesity and appreciated the supportive forum that group-based programming provided for sharing experiences. Since experiences of blame and isolation can burden caregivers of children with obesity, paediatric weight management programmes might consider including peer support opportunities and discussion forums for ongoing social support in addition to education about lifestyle change.

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“…Clinicians and HCMs in our study reported concordant barriers to effective weight management, echoing previous research, in particular, the issue of patient attrition was highlighted. [38] Rates of attrition for pediatric weight management services have been reported as high as 42% [39], with up to 80% of families ceasing treatment early [40,41]. Reasons for attrition include logistical issues required to attending frequent appointments during work/school hours, the service experience not meeting family expectations [40], the length of follow-up [42], lack of weight loss [43], and the perceived stigma of attending a weight management clinic [39].…”

Section: Discussionmentioning

confidence: 99%

Clinician perspectives on models of care for pediatric weight management services in Australia: A mixed-methods study

Cohen¹,

Alexander²,

Signorelli³

et al. 2019

Preprint

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Introduction For children with moderate to severe obesity, secondary and tertiary level services provide a platform for a more intensive approach toward weight management. Clinician and health care managers’ (HCM) views are imperative for informing the nature of future services to treat such children. Methods This concurrent mixed-methods study utilized questionnaires and semi-structured focus groups with clinicians, and one-on-one semi-structured interviews with HCMs, who worked in six secondary or tertiary pediatric weight management clinics across five public hospitals in New South Wales, Australia. The Theoretical Domains Framework was employed to underpin the development of the interview guides. The recorded interviews were transcribed verbatim and coded line-by-line, noting the key emerging themes. The results from the questionnaire were analyzed using descriptive statistics. Results Clinicians (n=27) provided multiple approaches to weight management, tailored to families and patients. Clinicians more often provided general healthy eating advice over a specific diet approach. Four-fifths used body mass index percentile change as a measure of success, as well as behavioral outcomes such as improvements in physical activity levels, screen time and sleep quality. Use of a combination of group and individual sessions were thought to improve engagement and reduce attrition rates. Clinicians and HCMs recommended integrating clinics into community centres and providing specific programs for sub-groups such as children from culturally and linguistically diverse communities or children with development delay. Many clinicians and HCMs stressed the importance of pediatric weight clinics using a holistic approach to treatment. Research into clinical outcomes for services was recommended to enable the development of a business case for further funding of pediatric weight management services. Conclusion Addressing common barriers to current pediatric weight management services, and designing future models of care based on key stakeholders’ preferences, are critical to achieving optimal care provision for this high risk population.

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Expectations for Treatment in Pediatric Weight Management and Relationship to Attrition

Abstract: Clinicaltrials.gov NCT01753063.

Cited by 34 publications

References 26 publications

Food addiction and preoperative weight loss achievement in patients seeking bariatric surgery

Food addiction and preoperative weight loss achievement in patients seeking bariatric surgery

Walking in the shoes of caregivers of children with obesity: supporting caregivers in paediatric weight management

Clinician perspectives on models of care for pediatric weight management services in Australia: A mixed-methods study

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