Stephanie G Harshman1,2, Ines Castro3, Meghan Perkins3, Man Luo3, Katelee Barrett Mueller3, Hellas Cena4,5, Sandra Portale4, Benedetta Raspini4, Elsie Taveras3, Lauren Fiechtner3,6,7. 1. Neuroendocrine Unit, Massachusetts General Hospital, 55 Fruit Street, Boston, MA, USA. sgharshman@gmail.com. 2. Eating Disorders Clinical and Research Program, Massachusetts General Hospital, 55 Fruit Street, Boston, MA, USA. sgharshman@gmail.com. 3. Division of General Academic Pediatrics, Department of Pediatrics, MassGeneral Hospital for Children, 125 Nashua Street, Suite 860, Boston, MA, USA. 4. Laboratory of Dietetics and Clinical Nutrition, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy. 5. Clinical Nutrition and Dietetics Service, Unit of Internal Medicine and Endocrinology, ICS Maugeri IRCCS, Pavia, Italy. 6. Department of Gastroenterology and Nutrition, MassGeneral Hospital for Children, 175 Cambridge St, Boston, MA, USA. 7. Greater Boston Food Bank, 70S. Bay Avenue, Boston, MA, 02118, USA.
Abstract
OBJECTIVE: To examine changes in prevalence of overeating behaviors in a comparative effectiveness study of two pediatric weight management interventions. METHODS: Four-hundred and seven children, ages 6-12 years, with a BMI ≥ 85th percentile were enrolled in a comparative effectiveness trial of two pediatric weight management interventions. Prevalence of "sneaking, hiding or hoarding food", and 'eating in the absence of hunger' was evaluated at baseline and 12 months. Statistical methods included McNemar's test and longitudinal logistic regression. RESULTS: Prevalence of "sneak, hide, or hoard food" significantly decreased in all participants from 29.1% to 20.7% at 12 months. The prevalence of "eating in the absence of hunger" decreased in all participants from 46.7% to 22.4% at 12 months. Use of SNAP benefits, free/reduced meals at school, parental stress, housing, and food insecurity at baseline were associated with an increased likelihood of endorsing overeating behaviors at 12 months. Conversely, those who engaged in at least one session of the pediatric weight management intervention were significantly less likely to endorse "eating in the absence of hunger" at 12 months. CONCLUSIONS: Participation in pediatric weight management interventions improves the prevalence of overeating behaviors and is associated with participant engagement and social determinants of health, specifically food security status. Efforts to engage populations impacted by food insecurity and other social determinants of health risk factors will be critical for success of weight management interventions. CLINICAL TRIAL REGISTRATION: This trial has been registered at ClinicalTrials.gov (identifier: NCT03012126).
OBJECTIVE: To examine changes in prevalence of overeating behaviors in a comparative effectiveness study of two pediatric weight management interventions. METHODS: Four-hundred and seven children, ages 6-12 years, with a BMI ≥ 85th percentile were enrolled in a comparative effectiveness trial of two pediatric weight management interventions. Prevalence of "sneaking, hiding or hoarding food", and 'eating in the absence of hunger' was evaluated at baseline and 12 months. Statistical methods included McNemar's test and longitudinal logistic regression. RESULTS: Prevalence of "sneak, hide, or hoard food" significantly decreased in all participants from 29.1% to 20.7% at 12 months. The prevalence of "eating in the absence of hunger" decreased in all participants from 46.7% to 22.4% at 12 months. Use of SNAP benefits, free/reduced meals at school, parental stress, housing, and food insecurity at baseline were associated with an increased likelihood of endorsing overeating behaviors at 12 months. Conversely, those who engaged in at least one session of the pediatric weight management intervention were significantly less likely to endorse "eating in the absence of hunger" at 12 months. CONCLUSIONS: Participation in pediatric weight management interventions improves the prevalence of overeating behaviors and is associated with participant engagement and social determinants of health, specifically food security status. Efforts to engage populations impacted by food insecurity and other social determinants of health risk factors will be critical for success of weight management interventions. CLINICAL TRIAL REGISTRATION: This trial has been registered at ClinicalTrials.gov (identifier: NCT03012126).
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