Presence of Obesity Related Comorbidities Associated with Lower Attrition Rate in Pediatric Weight Management Program

Background: Multidisciplinary pediatric weight management clinics have reported varying effectiveness in childhood obesity and they faced a common issue of high attrition rate. The effectiveness of pediatric weight management clinic and predictors of attrition has not been described in a multiracial Singapore population.

Objectives: The aim of the study is to determine whether a dedicated multidisciplinary pediatric weight management program in a single center tertiary institution effectively reduces Body Mass Index (BMI) Z-Scores and cardiovascular risk factors in children with obesity aged 2-16 years old pre post intervention and to examine the factors that predict attrition from the program.

Methods: This is a single center retrospective study, where medical records of patients enrolled in KK Women’s and Children’s Hospital paediatric weight mangement clinic over a 14 months period was reviewed. The program is a multicomponent family based clinic that utilizes medical management, dietary and physical activity counseling and intervention. Inclusion criteria for enrollment in the program was more than 2 years of age with BMI of more than 90^th percentile. Attenders were defined as attending more than ≥ 2 clinic visit. Analyses were performed to identify factors associated with changes in BMI Z-Score and cardiovascular risk factors and attrition from the program.

Results: A total of 121 patients were enrolled in the pediatric weight management program and 68% had obesity related comorbidities with dyslipidemia being the most common followed by hypertension. There were 51 attenders and presence of obesity related comorbidities predicted lower attrition rate (p=0.05). The attenders had a significant reduction in mean BMI Z-Score of 0.082 (95% CI,-0.13 to -0.033) (p=0.001) with significant improvements in high-density lipoprotein level and total cholesterol to high- density lipoprotein level (p<0.05).

Conclusions: A multidisciplinary pediatric weight management program can improve the overweight status and the cardiovascular risk factors. Attrition factors should be studied to minimize defaulting rates.

Author(s):

Wei Jie Nicholas Hong, Hui Ling Huang, Kumudhini Rajasegaran, Jean Yin Oh, Siobhan Kelly, Seyed Ehsan Saffari and Chu Shan Elaine Chew

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