Background: The prevalence of pediatric obesity has increased over the last 30 years resulting inan earlier onset of obesity-related comorbidities. The greatest acceleration of Body Mass Index(BMI) in children has been reported to occur between the ages of 2 and 6 and is associated with anincreased risk of sustained obesity in adulthood. Objectives: The purpose of this study is to assess the characteristics of overweight (BMI at orabove 85th percentile) pediatric patients and current management trends in a single academicoutpatient clinic setting. Design/Methods: This IRB approved retrospective study conducted a chart review of pediatricpatients that presented to an outpatient clinic in an academic setting between October 1st, 2016 andDecember 31st, 2019. Inclusion criteria were patients aged 2 through 17, who presented for theirhealth maintenance visit, with a documented BMI at or above the 85th percentile. Exclusion criteriawere patients with a BMI less than the 85th percentile, age less than 2 or greater than 17, orincomplete documentation. The retrospective chart reviewed identified patient demographics and current practice. Results: A total of 1,086 patients met inclusion criteria; 50.0% were female, and 25.8% percent ofpatients were aged 3 and under with a median age of 7 years. Obesity was documented in 45.8% ofpatients. Amongst patients meeting inclusion criteria, 22.3% had a BMI at or above the 99thpercentile. Twenty-three percent (197/845) of patients with a documented blood pressure had asystolic or diastolic value at or above the 90th percentile. Hemoglobin A1C was ordered leastfrequently at 12.0% of visits, and 29% (23/78) resulted abnormal. Triglycerides were elevated in43.6% (119/271) of patients tested and represented the most frequently abnormal reported lab.Abdominal ultrasound was obtained in 1.9% of patients and identified steatosis in 14% (3/21) ofthose patients. A larger percentage of BMI decrease was observed in patients who followed-up at30-90 days when compared to those with follow-up at 181-365 days [% with decrease: 54.2% for30–90, 41.4% for 181–365; difference: 12.8%; 95% CI: (-2.4%, 27.3%)]. Conclusion: This study demonstrates a high prevalence of overweight and obese children withlaboratory and imaging abnormalities. The findings also demonstrate a large variation in currentmanagement. Perhaps most useful, the findings indicate the possibility of a greater decrease in BMIwith earlier follow-up.
Edlibi S, Rogers R, Abdo D, Owusu-Asare C, Wassef R, Coffey M, Qu L, Pollak A, Shubeck S, Mychaliska K. Current state of pediatric obesity: management trends in an outpatient pediatric clinic. Abstract presented at: Midwest Society for Pediatric Research 2021 Virtual Scientific Meeting. 2021 Oct 13-15; virtual.