The relationship of health outcomes to improvement in BMI in children and adolescents.

OBJECTIVE: To evaluate the clinical outcomes of patients participating in an outpatient program for managing childhood and adolescent obesity. RESEARCH METHODS AND PROCEDURES: Based on a retrospective chart review, 394 physician-referred obese youth (BMI > 95th percentile), 5 to 19 years of age, were treated in an interdisciplinary, family-centered, behavioral weight management program in a hospital-based outpatient setting. Treatment included group exercise, parent education, and behavioral intervention therapies to improve diet and physical activity.
RESULTS: A total of 177 (45%) completed the initial phase of treatment (mean duration = 5.6 months). For the completion group, there were significant improvements (all p < 0.001) in weight (-2.0 +/- 4.9 kg), BMI (-1.7 +/- 1.9 kg/m(2)), and BMI z score (-0.15 +/- 0.15), without interfering with growth (height, 2.2 +/- 1.3 cm; p < 0.001). Significant improvement was also found for blood pressure, total cholesterol, low-density lipoprotein (LDL)-cholesterol, triglycerides, insulin, and aerobic fitness. At onset of treatment, 134 (84%) patients had abnormal fasting insulin concentration, 88 (50%) had abnormal total cholesterol, 14 (8%) had abnormal diastolic blood pressure, and 69 (40%) had abnormal LDL-cholesterol. At the end of treatment, a significant proportion of patients with baseline abnormal blood pressure, total cholesterol, and LDL-cholesterol had normal values (p < 0.001). A decrease in BMI z score was associated with significant improvements in insulin and lipid values (all p < 0.05). DISCUSSION: We have demonstrated that a modest decrease in BMI in an ongoing clinical pediatric weight management program is accompanied by significant improvements in related health measures. These results may be helpful in counseling families with overweight children and adolescents.