A Retrospective Chart Study of a Comprehensive Medical Weight Loss Approach to Pediatric Obesity: Initial Results from the BOUNCE Program

Obesity is one of the most significant health problems facing children and adolescents. The definition of overweight in children is a body mass index between the 85th and less than 95th percentile, whereas obesity is greater than or equal to the 95th percentile for age and sex. There are multiple comorbidities associated with obesity, including dyslipidemia, hypertension, type 2 diabetes, sleep apnea, and nonalcoholic fatty liver disease, as well as psychosocial issues. Contributors to obesity are multifactorial, including genetic and environmental factors. Environmental factors associated with obesity include increased availability of inexpensive fast food, sugar-sweetened beverages, and high-fat and -sugar convenience foods; decreased exercise; and increased screen time. Treatment begins with behavioral interventions focusing on dietary modifications and increasing physical activity. Although medications to treat obesity are an area of increased interest, options in the pediatric population are limited. Currently, orlistat is the only FDA-approved option. For the treatment of severe obesity, bariatric surgery should be considered, based on age, weight, and associated comorbidities. Weight loss associated with surgery is robust and long-lasting and results in improvement in/resolution of multiple comorbidities. However, benefits should also be weighed against the long-term risks of vitamin deficiency. This review contains 73 references, 3 figures, and 3 tables. Key words: bariatric surgery, metabolic syndrome, obesity treatment, pediatric obesity, weight loss surgery

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Self-monitoring As A Predictor For Weight Loss In A Family-based Pediatric Obesity Treatment Program

Medicine & Science in Sports & Exercise ◽

10.1249/01.mss.0000519693.53674.7f ◽

2017 ◽

Vol 49 (5S) ◽

pp. 986

Author(s):

Ava Coughlin ◽

Kate Heelan ◽

Todd Bartee

Keyword(s):

Weight Loss ◽

Treatment Program ◽

Pediatric Obesity ◽

Obesity Treatment ◽

Self Monitoring ◽

Family Based ◽

Pediatric Obesity Treatment

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Trends in pediatric obesity management, a survey from the Pediatric Endocrine Society Obesity Committee

Journal of Pediatric Endocrinology and Metabolism ◽

10.1515/jpem-2019-0546 ◽

2020 ◽

Vol 33 (4) ◽

pp. 469-472 ◽

Cited By ~ 2

Author(s):

Ashley H. Shoemaker ◽

Stephanie T. Chung ◽

Amy Fleischman ◽

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Keyword(s):

Bariatric Surgery ◽

Weight Loss ◽

Pediatric Obesity ◽

Online Survey ◽

Treatment Options ◽

The United States ◽

Pediatric Endocrinology ◽

Lifestyle Modifications ◽

Endocrine Society ◽

Weight Loss Medications

AbstractBackgroundIn the United States, 18.5% of children are obese. Dietary and lifestyle modifications are key, but often ineffective. There are limited approved pediatric pharmacotherapies. The objective of this study was to evaluate current treatment practices for pediatric obesity among members of the Pediatric Endocrine Society (PES, n = 1300) and the Pediatric Obesity Weight Evaluation Registry (POWER, n = 42) consortium.MethodsA 10-question online survey on treatment of children with obesity in clinical practice was conducted.ResultsThe response rates were 19% for PES and 20% for POWER members. The majority were female (65%) and board certified in pediatric endocrinology (81%). Most practitioners saw 5–10 patients with obesity/week and 19% prescribed weight-loss medications. POWER participants were more likely to prescribe weight-loss medications than PES participants (46% vs. 18%, p = 0.02). Metformin was the most commonly prescribed medication. Response to medication was poor. Use of dietary non-pharmacological treatment options was uncommon. Over half of the respondents (56%) referred patients for bariatric surgery and 53% had local access to pediatric bariatric surgery.ConclusionsMetformin was the most common drug prescribed among respondents, but successful weight-loss responses were uncommon. Among practitioners who are using pharmacological interventions, therapeutic strategies vary widely. Targeted research in pharmacologic and surgical treatment for pediatric obesity is urgently needed.

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Weight and Inch Changes in Subjects Enrolled in a Medical Weight Loss Management Program With and Without Medical Nutrition Therapy

Journal of the American Dietetic Association ◽

10.1016/s0002-8223(97)00487-2 ◽

1997 ◽

Vol 97 (9) ◽

pp. A47

Author(s):

K. McMahon ◽

H. Wengreen ◽

N. Schvaneveldt

Keyword(s):

Weight Loss ◽

Nutrition Therapy ◽

Management Program ◽

Medical Nutrition Therapy ◽

Medical Weight Loss ◽

Medical Nutrition

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The effect of a primary care-based Medical Weight Loss Program on weight loss and anthropomorphic metrics

Family Practice ◽

10.1093/fampra/cmaa050 ◽

2020 ◽

Author(s):

Vivienne A Rose ◽

Elena N Klyushnenkova ◽

Min Zhang ◽

Verlyn O Warrington

Keyword(s):

Primary Care ◽

Weight Loss ◽

Care Setting ◽

Primary Care Practice ◽

Primary Care Setting ◽

Weight Loss Program ◽

Care Practice ◽

Control Group ◽

Baseline Weight ◽

Medical Weight Loss

Abstract Background Diet and lifestyle intervention programs have been shown to be effective in decreasing obesity/overweight and many associated comorbidities in specialty research settings. There is very little information however as to the efficacy of such programs conducted in usual/typical primary care practices. We analysed effectiveness of the Medical Weight Loss Program (MWLP) designed to specifically address overweight/obesity in the setting of an urban academic primary care practice. Objective To determine whether participation in the MWLP within a general primary care setting can result in weight loss. Methods A retrospective medical chart review of patients treated in MWLP and a control group of patients with obesity receiving regular care in the general primary care setting. From the practice database (1 April 2015–31 March 2016), 209 patients (≥18 years old) who participated in the MWLP were identified; 265 controls were selected from the remaining population based on the presence of the obesity-related diagnoses. Results MWLP patients lost on average 2.35 ± 5.88 kg in 6 months compared to their baseline weight (P < 0.0001). In contrast, the control group demonstrated a trend of gaining on average 0.37 ± 6.03 kg. Having three or more visits with the MWLP provider within 6 months after program initiation was the most important factor associated with successful loss of at least 5% of the baseline weight. Weight loss also correlated with a decrease in abdominal girth. Conclusion MWLP integrated into the general primary care practice may potentially be an effective model for managing obesity and related morbidities.

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