THE EFFECT OF A GOAL – DIRECTED PRIMARY CARE INTERVENTION ON PEDIATRIC OBESITY

Introduction and Objective: The prevalence of pediatric obesity is greater now than at any other point in history. The ramifications of this epidemic are higher rates of pediatric medical complications, such as elevated lipid concentrations and blood pressure. Also, a higher proportion of obese children become obese adults, with risk for conditions such as diabetes, cardiovascular disease and certain cancers. Our study addressed the efficacy of family based physician interventions to decrease the Body Mass Index (BMI) of obese children as defined by BMI for age ≥ 95th percentile. Method: Children between 8-13 years old and BMI percentile for age ≥ 95th were eligible for the study. Twenty-nine initial subjects were randomized into an intervention group and an observed control group. The intervention group received monthly physician led group counseling sessions for 6 months via the ‘We Can!’ program. Eight participants eventually followed up for height and weight measurements. Results and Conclusions: There were no significant differences noted between the intervention and control groups for change in BMI or change in activity scores based on evaluations. The study had a high attrition rate. Parents cited issues with time commitments, forgetting meetings, and lack of interest as barriers to completion. Our study suggests that improvement in pediatric obesity may require a broader approach than just education by a primary care manager. Further studies with multiple intervention modalities are needed to determine the potential impact of family based group physician intervention in decreasing the BMI of previously diagnosed obese children.