ResultsParticipants:• 152 Group program and 189 control participants were ≥9 years old and did not significantly differ by demographics or baseline BMI• Mean baseline BMI Percentile and BMI z-score were 98.8% (SD=0.9) and 2.37 (SD=0.29) for Group program participants, and 98.7% (SD=1.0) and 2.33 (SD=0.29) for control

participants• Group program and control participants were further divided into those with BMI 95-98.9% and those with BMI≥99th%ile to examine demographics and anthropometric

outcomes by severity of obesity

• Overall, Group program participants’ BMI z-score significantly improved during the active intervention and up to two years from starting the active intervention. Control participants’ BMI z-scores also significantly improved over these time periods (p<.0001 for both). There was no significant difference in these improvements between Group program and control participants.

• Group program and control participants with severe obesity also significantly improved their weight status over two years (p<.0001 for both). There was no significant difference in improvements between Group program and control participants.

• Group program and control participants with less severe obesity demonstrated no significant change in their weight status over two years, nor were the two groups’ progress different.

• Upon additional analysis, there was no significant difference in BMI z-score between Group program and control participants when evaluating preteens (9-12 yo) vs. teens (13-19 yo). When evaluating group program length, significant improvements over time were found for the 6-month Group program and control participants but not the 12-week Group program participants(data not shown).

How do Long-term Outcomes of Weight Management Group Programming Compare to Standard Care?

Sarah E Hampl1,2, Kelsey M Dean2, Ashley K Sherman1, Amy E Papa2 and Meredith Dreyer Gillette1,2 1Children's Mercy Hospital, Kansas City, MO, United States;

2Center for Children's Healthy Lifestyles & Nutrition, Kansas City, MO, United States

Background• The US Preventive Services Task Force

recommends that children with obesity receive moderate- to high-intensity comprehensive multidisciplinary intervention of ≥26 contact hours (Whitlock et al, 2010). This is most consistent with Expert Committee Stage 3 (Comprehensive Multidisciplinary Intervention) treatment (Spear et al, 2007).

• Delivering these interventions in group formats is more cost-effective than individual treatment (Goldfield et al, 2001).

• Information about long-term (>12 months) outcomes of these programs and how these outcomes compare to children receiving standard care is limited (Ho et al, 2012).

Conclusions• Both Group program and control

participants’ weight status improved up to two years after starting active treatment.

• There was no significant difference in these improvements between Group program and control participants.

• When participants with severe obesity were separately evaluated, significant improvements in both Group program and control participant weight status were found. The difference between the Group program and control participants was not significant.

• Weight status of Group program and control participants with less severe obesity did not significantly improve.

• Weight status improvement in younger (9-12 yo) vs. older (13-19 yo) participants was not significantly different, but those who received a longer active intervention had significant improvement over two years, whereas those receiving a briefer active intervention did not.

• Limitations of the study include small sample size at follow up points, hindering evaluation of long-term weight and lab outcomes, and lack of examination of insurance status.

MethodsProcedures:• Group participants were drawn from the

Promoting Health in Teens and Kids (PHIT Kids) program, a 3-6 month, 2 hour weekly behaviorally-based intervention at a Midwest children’s hospital. The active intervention duration ranged from 26-52 hours. Participants began the group in 2006-2010 and were followed for 2 years.

• Age-, sex-, race/ethnicity- and BMI-matched standard care participants with visits approximating baseline and 6-month intervals were drawn from the hospital’s General Pediatrics clinic.

• Participant demographic and

anthropometric data were drawn from the patient’s electronic medical record. Prior to collecting data from the EMR, the study was approved by the IRB.

Measures:• Patient anthropometric data (i.e., height,

weight) was measured at each visit. Child height and weight were used to calculate BMI, BMI percentile, and BMI z-score using the Centers for Disease Control BMI calculator for SAS™.

References• Whitlock EP, O’Connor EA, Williams SB, Beil TL, Lutz KW,

Effectiveness of weight management interventions in children: A targeted systematic review for the USPSTF. Pediatr 2010;125:e396-e418.

• Spear BA, Barlow SE, Ervin C, Ludwig DS, Saelens BE, Schetzina KE, Taveras EM. Recommendations for treatment of child and adolescent overweight and obesity. Pediatr 2007;120:S254-S288.

• Goldfield GS, Epstein LH, Kilanowski CK, Paluch RA, Kogut-Bossler B. Cost-effectiveness of group and mixed family based treatment for childhood obesity. Int J Obes Relat Metab Disord. 2001;25:1843–1849.• Ho M, Garnett SP, Baur L, Burrows T et al. Effectiveness

of lifestyle interventions in child obesity: Systematic review with meta-analysis. Pediatr 2012;130:e1647-e1671.

Acknowledgements• . The authors thank the Healthcare Foundation of

Greater Kansas City and the Junior League of Kansas City for their support of the group program

Contact Information• For more information, contact Sarah Hampl, MD at

shampl@cmh.edu. CD001872.pub2.

Table 1.

Group < 99th%ile (n=65)

Control <99th%ile (n=93)

Group ≥99th%ile (n=87)

Control ≥99th%ile(n=96)

p-value

Sex (%female) 64.6 61.3 60.9 68.7 0.66Ethnicity (%) <0.01 White 36.9 43.0 27.6 28.1 Black 24.6 26.9 56.3 56.3 Hispanic 33.9 26.9 14.9 15.6 Other 4.6 3.2 1.2 0Age [mean (SD)] 11.97 (1.94) 12.28 (2.10) 12.26 (2.44) 12.77 (2.35) 0.14

Table 1. Baseline demographics by weight status

Figure 1. Change in BMI z-score over 24 months for overall sample of Group program and control participants. Models run after controlling for demographics were not different.

Figure 2. Change in BMI z-score over 24 months for Group program and control participants by severity of obesity. Models run after controlling for demographics were not different.