MATERNAL BUT NOT PATERNAL OBESITY IS ASSOCIATED WITH CHILDHOOD OVERWEIGHT AND REDUCED RESPONSE TO WEIGHT MANAGEMENT TREATMENT

Abstract

Background: The association of parental obesity with pediatric overweight is well established, but whether parental obesity is associated with success in weight-management programs is unknown. The study aim was to examine the association of parental obesity with childhood overweight and success in a weight management program. Methods: Retrospective chart review of patients seen from June 2003 to November 2005 in the NEW Kids Program, a family-based clinic for children 2-18 years with BMI ≥95th percentile and a weight-related comorbidity. The program utilizes medical and behavioral management combined with nutrition and physical activity education. Results: 501 patients were seen during the study period, including 370 patients seen for follow-up. 42% of patients were white; 38%, African-American; 11%, Latino; 10%, other; and 56% were female. The mean BMI of patients at intake was 36 kg/m2 (±9). Patients with obese mothers (BMI ≥ 30) had a significantly higher mean BMI z-score than patients with normal-weight mothers (2.68 vs 2.5, P <.001). There was no significant association with father's BMI, but there was a significantly higher mean BMI z-score when both parents were obese (2.70 vs 2.26, P =.005). The group as a whole had a significant decrease in mean BMI z-score during treatment (−.043; P <.001). Patients with obese mothers had a significantly lower mean decrease in BMI z-score compared with patients with normal-weight mothers (−.02 vs −.07, respectively; P =.001), but paternal obesity showed no association, except when both parents were obese (−.025 vs −.07, P <.05). Conclusion: Maternal, but not paternal, obesity is associated with childhood overweight and a significantly lower reduction in BMI z-score in a multi-disciplinary weight management program. The findings suggest that screening for maternal obesity may be a useful means of identifying overweight children at higher risk of treatment failure, and concomitant treatment of maternal obesity could enhance weight management treatment success in children.