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Published in: Health and Quality of Life Outcomes 1/2013

Open Access 01-12-2013 | Research

Quality of life and BMI changes in youth participating in an integrated pediatric obesity treatment program

Authors: Keeley J Pratt, Suzanne Lazorick, Angela L Lamson, Andrada Ivanescu, David N Collier

Published in: Health and Quality of Life Outcomes | Issue 1/2013

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Abstract

Background

Changes in Quality of Life (QOL) measures over time with treatment of obesity have not previously been described for youth. We describe the changes from baseline through two follow up visits in youth QOL (assessed by the Pediatric Quality Life Inventory, PedsQL4.0), teen depression (assessed by the Patient Health Questionnaire, PHQ9A), Body Mass Index (BMI) and BMI z-score. We also report caregiver proxy ratings of youth QOL.

Methods

A sample of 267 pairs of youth and caregiver participants were recruited at their first visit to an outpatient weight-treatment clinic that provides care integrated between a physician, dietician, and mental health provider; of the 267, 113 attended a visit two (V2) follow-up appointment, and 48 attended visit three (V3). We investigated multiple factors longitudinally experienced by youth who are overweight and their caregivers across up to three different integrated care visits. We determined relationships at baseline in QOL, PHQ9A, and BMI z-score, as well as changes in variables over time using linear mixed models with time as a covariate.

Results

Overall across three visits the results indicate that youth had slight declines in relative BMI, significant increases in their QOL and improvements in depression.

Conclusions

We encourage clinicians and researchers to track youth longitudinally throughout treatment to investigate not only youth’s BMI changes, but also psychosocial changes including QOL.
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Literature
1.
go back to reference Federal Interagency Forum on Child and Family Statistics: America’s children: Key national indicators of well-being. Washington, DC: U.S. Government Printing Office; 2007. Federal Interagency Forum on Child and Family Statistics: America’s children: Key national indicators of well-being. Washington, DC: U.S. Government Printing Office; 2007.
2.
go back to reference Hedley A, Ogden C, Johnson C, Carroll M, Curtin L, Flegal K: Prevalence of overweight and obesity among US children, adolescents and adults, 1999–2002. J Am Med Assoc 2004, 291: 2847–2850. 10.1001/jama.291.23.2847CrossRef Hedley A, Ogden C, Johnson C, Carroll M, Curtin L, Flegal K: Prevalence of overweight and obesity among US children, adolescents and adults, 1999–2002. J Am Med Assoc 2004, 291: 2847–2850. 10.1001/jama.291.23.2847CrossRef
3.
go back to reference Ogden CL, Carroll MD, Kit BK, Flegal KM: Prevalence of obesity and trends in body mass index among US children and adolescents, 1999–2010. J Am Med Assoc 2012, 307: 483–490. 10.1001/jama.2012.40CrossRef Ogden CL, Carroll MD, Kit BK, Flegal KM: Prevalence of obesity and trends in body mass index among US children and adolescents, 1999–2010. J Am Med Assoc 2012, 307: 483–490. 10.1001/jama.2012.40CrossRef
4.
go back to reference Barlow S, the Expert Committee: Expert committee recommendations regarding the prevention, assessment, and treatment of child and adolescent overweight and obesity: summary Report. Pediatrics 2007, 120: 164–192.CrossRef Barlow S, the Expert Committee: Expert committee recommendations regarding the prevention, assessment, and treatment of child and adolescent overweight and obesity: summary Report. Pediatrics 2007, 120: 164–192.CrossRef
5.
go back to reference Engle G: The need for a new medical model: a challenge for biomedicine. Science 1977, 196: 129–136. 10.1126/science.847460CrossRef Engle G: The need for a new medical model: a challenge for biomedicine. Science 1977, 196: 129–136. 10.1126/science.847460CrossRef
6.
go back to reference Janicke D: Impact of psychosocial factors on quality of life in overweight youth. Obesity 2007, 15: 1799–1807. 10.1038/oby.2007.214PubMedCrossRef Janicke D: Impact of psychosocial factors on quality of life in overweight youth. Obesity 2007, 15: 1799–1807. 10.1038/oby.2007.214PubMedCrossRef
7.
go back to reference Ravens-Sieberer U, Redegeld M, Bullinger M: Quality of life after in-patient rehabilitation in children with obesity. Int J Obes Relat Metab Disord 2001, 25: 63–65.CrossRef Ravens-Sieberer U, Redegeld M, Bullinger M: Quality of life after in-patient rehabilitation in children with obesity. Int J Obes Relat Metab Disord 2001, 25: 63–65.CrossRef
8.
go back to reference Schwimmer J, Burwinkle T, Varni J: Health-related quality of life of severely obese children and adolescents. J Am Med Assoc 1813, 2003: 289. Schwimmer J, Burwinkle T, Varni J: Health-related quality of life of severely obese children and adolescents. J Am Med Assoc 1813, 2003: 289.
9.
go back to reference Swallen K, Reither E, Haas S, Meier A: Overweight, obesity and health-related quality of life among adolescents: the national longitudinal study of adolescent health. Pediatrics 2005, 115: 340–347. 10.1542/peds.2004-0678PubMedCrossRef Swallen K, Reither E, Haas S, Meier A: Overweight, obesity and health-related quality of life among adolescents: the national longitudinal study of adolescent health. Pediatrics 2005, 115: 340–347. 10.1542/peds.2004-0678PubMedCrossRef
10.
go back to reference Williams J, Wake M, Hesketh K, Maher E, Waters E: Health-related quality of life of overweight and obese children. J Am Med Assoc 2005, 283: 70–76.CrossRef Williams J, Wake M, Hesketh K, Maher E, Waters E: Health-related quality of life of overweight and obese children. J Am Med Assoc 2005, 283: 70–76.CrossRef
11.
go back to reference Zeller M, Roehrig H, Modi A, Daniels S, Inge T: Health-related quality of life and depressive symptoms in adolescents with extreme obesity presenting for bariatric surgery. Pediatrics 2006, 117: 1155–1161. 10.1542/peds.2005-1141PubMedCrossRef Zeller M, Roehrig H, Modi A, Daniels S, Inge T: Health-related quality of life and depressive symptoms in adolescents with extreme obesity presenting for bariatric surgery. Pediatrics 2006, 117: 1155–1161. 10.1542/peds.2005-1141PubMedCrossRef
12.
go back to reference Epstein L, Paluch R, Gordy C, Saelens B, Ernst M: Problem solving in the treatment of childhood obesity. Journal of Counseling and Clinical Psychology 2000, 68: 717–721.CrossRef Epstein L, Paluch R, Gordy C, Saelens B, Ernst M: Problem solving in the treatment of childhood obesity. Journal of Counseling and Clinical Psychology 2000, 68: 717–721.CrossRef
13.
go back to reference Britz B, Siegfried W, Ziegler A, et al.: Rates of psychiatric disorders in a clinical study group of adolescents with extreme obesity and in obese adolescents ascertained via a population based study. Int J Obes 2000, 24: 1707–1714. 10.1038/sj.ijo.0801449CrossRef Britz B, Siegfried W, Ziegler A, et al.: Rates of psychiatric disorders in a clinical study group of adolescents with extreme obesity and in obese adolescents ascertained via a population based study. Int J Obes 2000, 24: 1707–1714. 10.1038/sj.ijo.0801449CrossRef
14.
go back to reference Patterson JE, Peek CJ, Heinrich RL, Bischoff RJ, Scherger J: Mental health professionals in medical settings: A primer. New York, NY: Norton; 2000. Patterson JE, Peek CJ, Heinrich RL, Bischoff RJ, Scherger J: Mental health professionals in medical settings: A primer. New York, NY: Norton; 2000.
15.
go back to reference Patient Healthcare Questionnaire. PRIME-MD. Pfizer Inc, PHQ-9 Copyright; 2000. Patient Healthcare Questionnaire. PRIME-MD. Pfizer Inc, PHQ-9 Copyright; 2000.
16.
go back to reference Chan K, Mangione-Smith R, Burwinkle T, Rosen M, Varni J: The PedsQL reliability and validity of the short-form generic core scales and asthma module. Medical Care 2000, 43: 256–265.CrossRef Chan K, Mangione-Smith R, Burwinkle T, Rosen M, Varni J: The PedsQL reliability and validity of the short-form generic core scales and asthma module. Medical Care 2000, 43: 256–265.CrossRef
17.
go back to reference Varni J: Measurement model for the pediatric quality of life inventory. Medical Care 1999, 37: 126–139. 10.1097/00005650-199902000-00003PubMedCrossRef Varni J: Measurement model for the pediatric quality of life inventory. Medical Care 1999, 37: 126–139. 10.1097/00005650-199902000-00003PubMedCrossRef
18.
go back to reference Varni J: Reliability and validity of the pediatric quality of life inventory version 4.0 generic core scales in healthy and patient populations. Medical Care 2001, 39: 800–812. 10.1097/00005650-200108000-00006PubMedCrossRef Varni J: Reliability and validity of the pediatric quality of life inventory version 4.0 generic core scales in healthy and patient populations. Medical Care 2001, 39: 800–812. 10.1097/00005650-200108000-00006PubMedCrossRef
19.
go back to reference Varni J: The PedsQL4.0 Generic Core Scales: sensitivity, responsiveness, and impact on clinical decision-making. J Behav Med 2002, 25: 175–193. 10.1023/A:1014836921812PubMedCrossRef Varni J: The PedsQL4.0 Generic Core Scales: sensitivity, responsiveness, and impact on clinical decision-making. J Behav Med 2002, 25: 175–193. 10.1023/A:1014836921812PubMedCrossRef
20.
go back to reference Varni J: The PedsQL4.0 as a pediatric population health measure: feasibility, reliability, and validity. Ambul Pediatr 2003, 3: 329–341. 10.1367/1539-4409(2003)003<0329:TPAAPP>2.0.CO;2PubMedCrossRef Varni J: The PedsQL4.0 as a pediatric population health measure: feasibility, reliability, and validity. Ambul Pediatr 2003, 3: 329–341. 10.1367/1539-4409(2003)003<0329:TPAAPP>2.0.CO;2PubMedCrossRef
21.
go back to reference Richardson L, McCauley E, Grossman D, McCarty C, Richards J, Russo J, Rockhill C: Evaluation of the patient health questionnaire-9 item for detecting major depression among adolescents. Pediatrics 2010, 126: 1117–1123. 10.1542/peds.2010-0852PubMedCentralPubMedCrossRef Richardson L, McCauley E, Grossman D, McCarty C, Richards J, Russo J, Rockhill C: Evaluation of the patient health questionnaire-9 item for detecting major depression among adolescents. Pediatrics 2010, 126: 1117–1123. 10.1542/peds.2010-0852PubMedCentralPubMedCrossRef
22.
go back to reference Spitzer RL, Kroenke K, Williams JB: The patient health questionnaire study group. Validity and utility of a self report version of PRIME-MD: the PHQ primary care study. J Am Med Assoc 1999, 282: 1737–1744. 10.1001/jama.282.18.1737CrossRef Spitzer RL, Kroenke K, Williams JB: The patient health questionnaire study group. Validity and utility of a self report version of PRIME-MD: the PHQ primary care study. J Am Med Assoc 1999, 282: 1737–1744. 10.1001/jama.282.18.1737CrossRef
23.
go back to reference Spritzer RL, Williams JB, Kroenke K, Hornyak R, McMurray J: Validity and utility of the PRIME-MD in assessment of 3,000 obstetric-gynecologic patients: The PRIMEMD patient health questionnaire obstetrics-gynecology study. Am J Obstet Gynecol 2000, 183: 759–769. 10.1067/mob.2000.106580CrossRef Spritzer RL, Williams JB, Kroenke K, Hornyak R, McMurray J: Validity and utility of the PRIME-MD in assessment of 3,000 obstetric-gynecologic patients: The PRIMEMD patient health questionnaire obstetrics-gynecology study. Am J Obstet Gynecol 2000, 183: 759–769. 10.1067/mob.2000.106580CrossRef
24.
go back to reference Cole T, Bellizzi M, Flegal K, Dietz W: Establishing a standard definition for child overweight and obesity worldwide: international survey. Br Med J 2000, 320: 1240–1243. 10.1136/bmj.320.7244.1240CrossRef Cole T, Bellizzi M, Flegal K, Dietz W: Establishing a standard definition for child overweight and obesity worldwide: international survey. Br Med J 2000, 320: 1240–1243. 10.1136/bmj.320.7244.1240CrossRef
25.
go back to reference Paluch R, Epstein L, Roemmich J: Comparison of methods to evaluate changes in relative body mass index in pediatric weight control. Am J Hum Biol 2007, 19: 487–494. 10.1002/ajhb.20608PubMedCrossRef Paluch R, Epstein L, Roemmich J: Comparison of methods to evaluate changes in relative body mass index in pediatric weight control. Am J Hum Biol 2007, 19: 487–494. 10.1002/ajhb.20608PubMedCrossRef
27.
go back to reference Gulati AK, Kaplan DW, Daniels SR: Clinical tracking of severely obese children: a new growth chart. Pediatrics 2012, 130: 1136–1140. 10.1542/peds.2012-0596PubMedCrossRef Gulati AK, Kaplan DW, Daniels SR: Clinical tracking of severely obese children: a new growth chart. Pediatrics 2012, 130: 1136–1140. 10.1542/peds.2012-0596PubMedCrossRef
28.
go back to reference Verbeke G, Molenberghs G: Linear Mixed Models for Longitudinal Data. New York, NY: Springer; 2000. Verbeke G, Molenberghs G: Linear Mixed Models for Longitudinal Data. New York, NY: Springer; 2000.
29.
go back to reference Pratt KJ, Lamson AL, Swanson MS, Lazorick S, Collier C: The importance of assessing for depression with HRQOL in treatment seeking youth and their caregivers. Qual Life Res 2012, 21: 1367–1377. 10.1007/s11136-011-0042-1PubMedCrossRef Pratt KJ, Lamson AL, Swanson MS, Lazorick S, Collier C: The importance of assessing for depression with HRQOL in treatment seeking youth and their caregivers. Qual Life Res 2012, 21: 1367–1377. 10.1007/s11136-011-0042-1PubMedCrossRef
30.
go back to reference Yao F, Muller HG, Wang JL: Functional data analysis for sparse longitudinal data. J Am Stat Assoc 2005, 100: 577–590. 10.1198/016214504000001745CrossRef Yao F, Muller HG, Wang JL: Functional data analysis for sparse longitudinal data. J Am Stat Assoc 2005, 100: 577–590. 10.1198/016214504000001745CrossRef
31.
go back to reference Skelton JA, Goff DC, Ip E, Beech BM: Attrition in a multidisciplinary pediatric weight management clinic. Childhood Obesity 2011, 7: 185–193.PubMedCentralPubMed Skelton JA, Goff DC, Ip E, Beech BM: Attrition in a multidisciplinary pediatric weight management clinic. Childhood Obesity 2011, 7: 185–193.PubMedCentralPubMed
32.
go back to reference Skelton JA, Beech BM: Attrition in paediatric weight management: a review of the literature and new directions. Obesity Rev 2011, 12: e273-e281. 10.1111/j.1467-789X.2010.00803.xCrossRef Skelton JA, Beech BM: Attrition in paediatric weight management: a review of the literature and new directions. Obesity Rev 2011, 12: e273-e281. 10.1111/j.1467-789X.2010.00803.xCrossRef
Metadata
Title
Quality of life and BMI changes in youth participating in an integrated pediatric obesity treatment program
Authors
Keeley J Pratt
Suzanne Lazorick
Angela L Lamson
Andrada Ivanescu
David N Collier
Publication date
01-12-2013
Publisher
BioMed Central
Published in
Health and Quality of Life Outcomes / Issue 1/2013
Electronic ISSN: 1477-7525
DOI
https://doi.org/10.1186/1477-7525-11-116

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