Stage 1 Treatment of Pediatric Overweight and Obesity: A Pilot and Feasibility Randomized Controlled Trial

Abstract

Background: Staged clinical treatment of pediatric obesity is recommended, but untested. Understanding the lowest intensity stage's effectiveness is necessary for future research.Methods: This was a randomized controlled trial of children ages 4 to < 9 years. Participants were recruited after routine evaluations at a primary care pediatric clinic revealed a BMI ‡ 85th percentile. The intervention was patterned after the ''Prevention plus, Stage 1'' treatment recommended by an expert committee. Groups were compared for changes, over a 3-month time period, in BMI z-score and parental reports of behavioral issues related to childhood obesity using intent-to-treat (ITT) analysis.Results: Seventy-two (30% of eligible) children were enrolled and 64 were remeasured at 3-month follow-up. ITT analysis revealed that both groups improved mean BMI z-score [adjusted change -0.07, control, and -0.04, intervention; 95% confidence interval (CI) of difference = -0.14-0.20]. Over half of the children in each group improved their BMI z-score (adjusted proportion decreasing = 55% in control vs. 72% in intervention; 95% CI of difference = -0.07-0.42). The intervention group improved comparatively to the control group on numerous behavioral indicators.Conclusions: Implementation of the lowest intensity stage of current recommendations is feasible and possibly of benefit toward lifestyle changes. Results of this study can be used by future clinical researchers designing protocols to test the full multi-staged approach for the treatment of pediatric overweight and obesity in primary care clinical settings.

In Children With Nonalcoholic Fatty Liver Disease, Cysteamine Bitartrate Delayed Release Improves Liver Enzymes but Does Not Reduce Disease Activity Scores

“…Change in weight status was defined by change in BMI z-score from baseline to week 52 as follows: 1) improved = a decrease of > 0.1; 2) stable = −0.1 to +0.1; 3) worsened = an increase of > 0.1. 27–29 …”

Randomized controlled trial of a Wellness Action Plan to promote healthy diet and activity in pediatric primary care

“…To our knowledge, however, no studies have examined action plans and parental recall of diet and activity goals in pediatric primary care. Several studies have reported interventions using goal establishment to improve adherence with changes in diet and activity regimens ( Perrin et al, 2010 , Schwartz et al, 2007 , McCallum et al, 2007 , Patrick et al, 2001 , Stovitz et al, 2014 ). However, goal creation in these studies was largely based on parents choosing goals from predefined lists of suggested behavior changes, rather than composing goals from scratch.…”

Layperson-Led vs Professional-Led Behavioral Interventions for Weight Loss in Pediatric Obesity

“…We initially identified 25 586 citations and, after removing duplicates, we reviewed 20 514 unique citations. Of those, 78 RCTs 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 , 77 , 78 , 79 , 80 , 81 , 82 , 83 , 84 , 85 , 86 , 87 , 88 , 89 , 90 , 91 , 92 ...…”