Family-Based Obesity Treatment in Children With Disabilities

OBJECTIVE: To assess the relative effectiveness of an interdisciplinary, family-centered, tertiary-care pediatric weight management program for the treatment of patients with and without cognitive disabilities (CD). METHODS: Retrospective analysis of the clinical database of a tertiary-care pediatric weight management clinic (n = 453), extracting data from electronic health records including longitudinal change in weight status (body mass index [BMI] z-score) and frequency of attrition from treatment. Upon review of medical records, children enrolled in the treatment program were classified as having no CD (n = 342) or CD (n = 111). RESULTS: At baseline, there were no between-group differences in BMI or BMI z-score. After 4 months of treatment, 66% (299) of patients remained enrolled, and complete case data were available for 219 children in final analyses. There were no statistically significant differences in attrition between the 2 groups (no CD vs CD). Mean change in BMI z-score across all groups was 0.03 +/- 0.13 (P <.001). Change in BMI z-score was significantly greater among patients with CD (-0.07 +/- 0.15) compared to those without CD (-0.03 +/- 0.12) (difference 0.04, 95% confidence interval 0.005-0.08, P =.029). These change estimates were observed after adjusting for processes potentially associated with attrition. CONCLUSIONS: Children with CD treated in an interdisciplinary, family-centered obesity clinic had similar or better outcomes compared to peers without CD. This success may be attributable to the patient-centered nature of this behavioral weight management program, which focused on leveraging the unique strengths and capabilities of each individual patient and family.