Vol. 2 No. 1 (2019): current Issue
Research Article

Energy Management for Personalized Weight Reduction (EMPOWER) Program: Three-Year Outcome Data

Vidmar AP
Center for Endocrinology, Diabetes and Metabolism, Department of Pediatrics, Children’s Hospital Los Angeles,Los Angeles, USA and The Diabetes & Obesity Program, Children’s Hospital Los Angeles and The Saban Research Institute, Departmentof Pediatrics, Children’s Hospital Los Angeles, Los Angeles, USA
Fink F
The Diabetes & Obesity Program, Children’s Hospital Los Angeles and The Saban Research Institute, Departmentof Pediatrics, Children’s Hospital Los Angeles, Los Angeles, USA
Mittelman SD
The Diabetes & Obesity Program, Children’s Hospital Los Angeles and The Saban Research Institute, Department of Pediatrics, Children’s Hospital Los Angeles, Los Angeles, USA and Department of Pediatrics, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, USA
Wee CP
CTSI Biostatics Core, Saban Research Institute, Los Angeles, USA
Torres B
The Diabetes & Obesity Program, Children’s Hospital Los Angeles and The Saban Research Institute, Department of Pediatrics, Children’s Hospital Los Angeles, Los Angeles, USA
Manzanarez B
The Diabetes & Obesity Program, Children’s Hospital Los Angeles and The Saban Research Institute, Department of Pediatrics, Children’s Hospital Los Angeles, Los Angeles, USA
Borzutzky C
The Diabetes & Obesity Program, Division of Adolescent and Young Adult Medicine, Children’s Hospital Los Angeles and Keck School of Medicine of USC, Los Angeles, USA

Published 2019-03-10

Keywords

  • Obesity,
  • Pediatrics,
  • Weight Loss,
  • Multi-Disciplinary Clinic

Abstract

Background: The current consensus guidelines for management of pediatric obesity recommend clinic-based, family-centered, multi-disciplinary interventions. It is well reported that these programs often only lead to modest improvements in BMI status. The individual factors that differentiate which patient’s BMI status will improve vs. worsen remains understudied. A retrospective cohort study was conducted to evaluate the outcomes of EMPOWER clinic and identify the participant specific characteristics that predicted BMI status improvement in this population.
Methods: Youth who completed at least 6 visits in EMPOWER were included. Paired t-test was utilized to evaluate the mean change in zBMI, modified BMIz and %BMIp95 from baseline to 6th visit, and multivariate mixed effect models were utilized to analyze effect of baseline characteristics on change in BMI status.
Results: 92 participants were included in the analysis, 87% with severe obesity and 66% Hispanic. At the 6th visit, there was a significant reduction in zBMI (-0.09 SD, p <0.001) and modified BMIz (-0.0003 SD, p = 0.04) with a small reduction in %BMIp95 (-1.15 %, p = 0.20). Lower BMI status (p < 0.001) and absence of a comorbidity (p < 0.05) at baseline were predictors of BMI status improvement whereas age, gender, ethnicity, family history of obesity and insurance status were not significant predictors.
Conclusions: Given that implementation of the current guidelines for management of obesity in pediatrics only results in modest BMI status reduction, further investigation is required to understand how the determinants of obesity-related health outcomes can guide development of more innovative, effective interventions for this high risk population.