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Endocrine

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27.06.2019 | Original Article

Multi-disciplinary weight management compared to routine care in youth with obesity: what else should be monitored?

verfasst von: Indrajit Majumdar, Brittany Espino, Kristina Bianco, Jeanette Epstein, Leena Mamilly, Carroll M. Harmon

Erschienen in: Endocrine | Ausgabe 2/2019

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Abstract

Purpose

Efficacy of multi-disciplinary weight management (MDM) in youth has not been compared to their routine care.

Objectives

To compare body mass index z-score (zBMI) and blood test (lab) changes (Δ) in youth before and after MDM and to correlate bio-impedance analysis (BIA) and lab measurements.

Methods

We compared zBMI Δ (from referring providers’ records), within 3 months prior to MDM, to monthly zBMI Δ after MDM, in a retrospective cohort of youth at a tertiary MDM center. BIA and lab measurements after 6 months, MDM were compared to baseline.

Results

We reviewed 316 records (12.9 ± 3.5 years, 49% males, 104.8 ± 35.1 kgs). The pre-MDM zBMI Δ (0.02 ± 0.1) was reversed after MDM (−0.03 ± 0.09, visit 2, P < 0.001). The zBMI Δ progressed on follow-up (−0.14 ± 0.05, visit 6). Baseline BIA components correlated with Homeostatic Model Assessment of Insulin resistance (HOMA-IR), triglycerides, and systolic blood pressure. HbA1c, HOMA-IR, and liver functions significantly improved on follow-up. MDM participation showed progressive attrition and dropped to 11.6% at visit 6.

Conclusion

MDM in youth resulted in zBMI and lab improvements compared to their pre-MDM measurements. BIA provided additional outcome measures that correlated with metabolic markers. MDM follow-up was limited by the progressive participant drop-out. Behavioral economic strategies are needed to improve adherence.

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Titel: Multi-disciplinary weight management compared to routine care in youth with obesity: what else should be monitored?
verfasst von: Indrajit Majumdar
Brittany Espino
Kristina Bianco
Jeanette Epstein
Leena Mamilly
Carroll M. Harmon
Publikationsdatum: 27.06.2019
Verlag: Springer US
Erschienen in: Endocrine / Ausgabe 2/2019
Print ISSN: 1355-008X
Elektronische ISSN: 1559-0100
DOI: https://doi.org/10.1007/s12020-019-01988-9

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Abstract

Purpose

Objectives

Methods

Results

Conclusion

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