Characteristics associated with successful treatment outcome in children with overweight and obesity at a tertiary care clinic in Sri Lanka

Abstract

Background: Lack of response to childhood obesity management programmes is a global concern. Western studies show that the age and the body mass index of the child at the commencement of the treatment, frequency of clinic visits and parental level of education affect the outcome of such treatment programmes.Objectives: To identify factors associated with z-BMI reduction in children with overweight or obesity who underwent a 6-month clinic-based obesity management programme.Methods: A retrospective analysis of medical records was carried out on children between 2 and 15 years of age who had undergone a weight management programme of 6 months duration at the Teaching Hospital, Peradeniya between 2017 and 2020. Reduction in z-BMI was considered as the successful treatment outcome. Anthropometric, demographic and lifestyle factors at the first and the last visits were extracted and described using means with 95% confidence intervals. Adherence to treatment was evaluated under the categories of diet, physical activity and behavioural modification. Logistic regression was applied to create a model that explains the effect on the treatment outcome.Results: Out of 401 subjects, 94 (23.44%) completed follow up. Eighty subjects (85.1%) achieved a mean z-BMI reduction of 1.981±0.584.The Logistic regression returned a model with screen time as the only statistically significant explanatory variable for changes in BMI. Compared to no screen time those with screen times of over 4 hours were 5.85 (CI 1.25 – 27.28) times more likely to have a negative response.Conclusion: Strategies to minimize screen time are needed to enhance the effectiveness of weight management interventions.