Oral Presentation ANZOS-Breakthrough Discoveries Joint Annual Scientific Meeting 2018

SERVICE PROVIDES; THE ADOLESCENT DECIDES: WEIGHT LOSS OUTCOMES IN A TERTIARY OBESITY SERVICE (#41)

Alicia Grunseit 1 2 , Sarah Young 3 , Kerryn Chisholm 1 2 , Shirley Alexander 1 , Natalie Lister 4 5
  1. Department of Weight Management Services, The Children's Hospital Westmead, Westmead, NSW, Australia
  2. Department of Nutrition and Dietetics, The Children's Hospital Westmead, Westmead, NSW, Australia
  3. Nutrition and Dietetics Group, School of Life Sciences, University of Sydney; The Charles Perkins Centre, Sydney, NSW, Australia
  4. Institue of Endocrine and Diabetes, the Childrens Hospital Westmead, Westmead, NSW, Australia
  5. Discipline of child and Adolescent health, University Of Sydney, Sydney, NSW, Australia

Background: Management of adolescent obesity requires a range of evidence –based dietary interventions1. This study explored the outcomes of a multidisciplinary weight management program for adolescents with obesity in a tertiary setting. The 6 month dietetic and medical led program offers adolescents the choice of 3 dietary interventions; a Very Low Energy Diet (VLED), Intermittent Energy Restriction (IER) and Higher Protein Diet (HPD).

Methods: A retrospective medical chart review of the Adolescent Weight Management Program at The Children’s Hospital at Westmead between October 2014 to December 2017 was conducted. Participants (n=57) aged 14-17y who engaged with the program were identified, and anthropometric data extracted for index calculations. Statistical analysis was intention-to-treat, and sub-group analysis was completed to compare sex, dietary interventions and attendance between engagers(n=47) and program completers (n=10).

Results: Weight- related outcomes significantly improved from baseline until last contact with the clinic: BMI z-score (-0.05±0.45, p<0.001), weight (-2.32±6.49kg, p=0.021), waist circumference (WC; -2.3±6.49cm, p=0.03), BMI (-1.06±2.08kg/m2, p=0.001), , BMI expressed as a percentage of the 95th percentile (BMI95; -7.89±12.19%, p<0.001) and Waist-to-Height ratio (WtHR; -0.02±0.16, p=0.01). Attendance decreased over time. Increased contact with the clinic significantly improved all weight-related outcomes. Adolescents who completed the program (n=10) had significant reductions in weight related outcomes, including BMI z-score (-0.15±0.13, p=0.021); and BMI95 (-7.63±7.46%, p=0.043). Girls (n=6) had greater reductions in BMI z-score and centile (-0.11±0.06, p=0.02 and -0.35±0.17, p=0.017) compared to boys. Changes in weight-related outcomes were greatest for adolescents following a VLED; n=16), particularly for BMI z-score (-0.12±0.11) and BMI95 (-5.44±6.19%), in comparison to the IER (-0.09±0.13, -3.49±4.68% respectively) and HPD (-0.05±0.13, -1.12±5.01% respectively).

Conclusions: The results demonstrate the effectiveness of real-world clinical practice for management of adolescent obesity. VLEDs produce greater weight reductions overall. Increased attendance at clinic lead to a significant improvement in all weight related outcomes.

 

  1. Lister NB, Gow ML, Chisholm K, Grunseit A, Garnett SP, Baur LA. Nutritional adequacy of diets for adolescents with overweight and obesity: considerations for dietetic practice. European Journal of Clinical Nutrition. 2017;71(5):646.