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United States Department of Agriculture

Agricultural Research Service

Research Project: Dietary Guidelines Adherence and Healthy Body Weight Maintenance Title: Indicated prevention of adult obesity: reference data for weight normalization in overweight children

Authors
item Goldschmidt, A -
item Wilfley, D -
item Paluch, Rocco -
item Roemmich, James
item Epstein, Leonard -

Submitted to: Archives of Pediatrics and Adolescent Medicine
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: March 27, 2012
Publication Date: January 1, 2013
Citation: Goldschmidt, A.B., Wilfley, D.E., Paluch, R.A., Roemmich, J.N., Epstein, L.H. 2013. Indicated prevention of adult obesity: reference data for weight normalization in overweight children. Archives of Pediatrics and Adolescent Medicine. 167:21-26.

Interpretive Summary: Background: Being obese as a child is a major risk factor for being obese as an adult. Indicated prevention--that is, helping overweight or obese youth attain non-overweight status--has been suggested to prevent adult obesity. Children and adolescents have an advantage when trying to attain a healthier weight because they can help normalize their weight through both weight control and by growing in height. This study aimed to support the notion of indicated prevention by demonstrating that relatively small weight changes can lead to non-overweight status for 8-13 year-old youth who are growing. Methods: We determined the amount of weight change necessary for overweight and obese youth to achieve non-overweight status based on modeling of longitudinal height growth patterns of 669 children (age 8-13y) who sought treatment for obesity and using CDC weight thresholds corresponding to age- and sex-adjusted body mass indices (BMIs; kg/m2) below the 85th percentile. We also calculated mean weight changes among children from our longitudinal sample who achieved non-overweight status at 1- and 2-years post-treatment. Results: Relatively small weight changes (range=-7.55kg to +2.44kg) were necessary for children to achieve non-overweight status after 1 year; this was most pronounced among younger children, and children closer to the 85th BMI percentile who didn't need to lose as much weight. Conclusion: Attaining non-overweight status in childhood is achievable with modest weight loss or, in some circumstances, by slowing weight gain, and may be a means of indicated prevention of adult obesity. Future research should investigate how much intervention is needed to shift the growth trajectory to non-overweight status, and how much weight change is needed to improve other health outcomes in adulthood.

Technical Abstract: Background: Pediatric obesity is a major risk factor for adult obesity. Indicated prevention--that is, helping overweight or obese youth attain non-overweight status--has been suggested to prevent adult obesity. This study aimed to support the notion of indicated prevention by demonstrating that relatively small weight changes can lead to non-overweight status for 8-13 year-old youth who are growing. Methods: We determined the amount of weight change necessary for overweight and obese youth to achieve non-overweight status based on linear mixed modeling of longitudinal growth patterns among 669 treatment-seeking children (age 8-13y) and using CDC weight thresholds corresponding to age- and sex-adjusted body mass indices (BMIs; kg/m2) below the 85th percentile. We also calculated mean weight changes among children from our longitudinal sample who achieved non-overweight status at 1- and 2-years post-treatment. Results: Relatively small weight changes (range=-7.55kg to +2.44kg) were necessary for children to achieve non-overweight status after 1 year; this was most pronounced among younger children, and children closer to the 85th BMI percentile. Observed weight changes of children who achieved non-overweight status following treatment were similar to weight change estimates based on CDC normative data. Conclusion: Attaining non-overweight status in childhood is achievable with modest weight loss or, in some circumstances, by slowing weight gain, and may be a means of indicated prevention of adult obesity. Future research should investigate how much intervention is needed to shift the growth trajectory to non-overweight status, and how much weight change is needed to improve other health outcomes in adulthood.

Last Modified: 8/1/2014