BOSTON – Childhood obesity is a growing problem, with especially high rates in Hispanic and Black children and in families with low income. In a recent randomized clinical trial in a largely Hispanic, low-income population, children who participated in a pediatric weight management program delivered at community health centers significantly improved their body mass index (BMI) over the course of one year. The study, which was conducted by a team led by investigators at Massachusetts General Hospital (MGH), is published in Pediatrics.
For the trial, 407 children aged six to 12 years with elevated BMI who were receiving care at two health centers participated in either a healthy weight clinic (HWC) program delivered at their health center by a team consisting of a pediatrician, a dietitian, and a community health worker or a weight management intervention offered at local YMCAs. A total of 4,037 children receiving care in other health centers served as a comparison group.
“We decided to conduct this study to find effective pediatric weight management interventions that could work in both the clinic and community for low-income children,” says lead author Lauren Fiechtner, MD, MPH, who is the director of Nutrition in the Division of Gastroenterology and Pediatric Health Outcomes Research at MassGeneral Hospital for Children (MGHfC) and an assistant professor of Pediatrics at Harvard Medical School.
Compared with the comparison group, children in the healthy weight clinic program had an average 0.23 decrease in BMI per year. This would represent a 1 pound weight loss annually in a 10-year-old child weighing 110 lbs. The program offered at local YMCAs did not appear to have an effect on children’s BMI. Children in the healthy weight clinic program also lowered their intake of sugary beverages and fast food, got more sleep, decreased their screen time, and boosted their physical activity.
“The multidisciplinary healthy weight clinic program was effective at reducing BMI among a low-income Hispanic population,” says Fiechtner. “Families in this effective intervention received care both in an individual setting with their healthy weight clinic team and in the group setting with other families with children with overweight or obesity. They also received text messaging and connections to community resources.”
The program has now been packaged for use in other primary care settings. “We hope to disseminate to other community health centers this effective pediatric weight management intervention that can help those most disproportionately affected by overweight and obesity,” says senior author Elsie Taveras, MD, MPH, who is chief Community Health Equity Officer at Mass General Brigham and a Professor of Pediatrics at Harvard Medical School.
Co-authors include Meghan Perkins, MPH, Vincent Biggs, MD, Nancy Langhans, MD, Mona Sharifi, MD, MPH, Sarah Price, MPH, Man Luo, MPH, Joseph J. Locascio, PhD, Katherine H. Hohman, DrPH, Heather Hodge, MEd, Steven Gortmaker, PhD, Shioban Torres, DrPH, and Elsie M. Taveras, MD, MPH.
Funding for the study was provided by the Centers for Disease Control and Prevention, the Eunice Kennedy Shriver National Institute of Child Health and Human Development, the Agency for Healthcare Research and Quality, and the National Institute of Diabetes and Digestive and Kidney Diseases.
About the Massachusetts General Hospital
Massachusetts General Hospital, founded in 1811, is the original and largest teaching hospital of Harvard Medical School. The Mass General Research Institute conducts the largest hospital-based research program in the nation, with annual research operations of more than $1 billion and comprises more than 9,500 researchers working across more than 30 institutes, centers and departments. In August 2021, Mass General was named #5 in the U.S. News & World Report list of "America’s Best Hospitals."