Patterns of Children's Weight Change During Family-Based Weight Management Intervention and Associations With Outcome Through Follow-Up

Abstract

Introduction

Understanding within-treatment weight change patterns may inform strategies to improve long-term outcomes for children with overweight/obesity.

Methods

Latent class modelling was applied to weekly weight change among 294 7–11-year-old children with overweight/obesity in behavioural weight management trials. Class differences in BMI z-score change through 1 year after treatment were examined using strict class assignment among completers (ANCOVA) or accounting for uncertainty in class assignment and missingness (Bolck, Croon and Hagenaars or BCH method).

Results

Three classes emerged—larger loss to stable weight (6% of children), consistent modest weight loss (43%) and moderate to decreasing weight loss (51%). During follow-up, the consistent modest weight loss class showed minimal change in BMI z-score whereas the other two classes increased (difference with moderate to decreasing weight loss class in ANCOVA = −0.096, p = 0.05; difference with large loss to stable class in BCH = −0.144, p = 0.017). The consistent modest weight loss class had the most favourable change from baseline through follow-up, better than the larger loss to stable weight class (ANCOVA difference = −0.189, p = 0.080; BCH difference = −0.186, p = 0.015).

Conclusion

Three patterns of within-treatment child weight change emerged, with modest consistent weight loss associated with more favourable distal child outcomes.