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International Journal of Pediatrics
Volume 2014 (2014), Article ID 152586, 7 pages
http://dx.doi.org/10.1155/2014/152586
Research Article

2-Year BMI Changes of Children Referred for Multidisciplinary Weight Management

1Division of General Pediatrics, Department of Medicine, Boston Children’s Hospital, Boston, MA 02115, USA
2Division of Behavioral Medicine, Department of Pediatrics, School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, NY 14214, USA
3Obesity Prevention Program, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA 02215, USA
4Division of General Pediatrics, Massachusetts General Hospital, Boston, MA 02114, USA

Received 7 October 2013; Accepted 12 December 2013; Published 30 January 2014

Academic Editor: Samuel Menahem

Copyright © 2014 Jennifer K. Cheng et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objective. To examine body mass index (BMI) changes among pediatric multidisciplinary weight management participants and nonparticipants. Design. In this retrospective database analysis, we used multivariable mixed effect models to compare 2-year BMI z-score trajectories among 583 eligible overweight or obese children referred to the One Step Ahead program at the Boston Children’s Primary Care Center between 2003 and 2009. Results. Of the referred children, 338 (58%) attended the program; 245 (42%) did not participate and were instead followed by their primary care providers within the group practice. The mean BMI z-score of program participants decreased modestly over a 2-year period and was lower than that of nonparticipants. The group-level difference in the rate of change in BMI z-score between participants and nonparticipants was statistically significant for 0–6 months ( ) and 19–24 months ( ); it was marginally significant for 13–18 months ( ) after referral. Younger participants (<5 years) had better outcomes across all time periods examined. Conclusion. Children attending a multidisciplinary program experienced greater BMI z-score reductions compared with usual primary care in a real world practice; younger participants had significantly better outcomes. Future research should consider early intervention and cost-effectiveness analyses.