How much weight loss = improved health in children?

In the world of adult weight management, 5 to 10% weight loss is associated with meaningful improvements in health outcomes. Indeed, many large-scale studies and interventions for adults have included 5 to 10% weight loss as a central goal (see HERE and HERE). 

However, in children with obesity, absolute weight loss is less relevant since changes in weight and height occur as a natural consequence of growth and development, with different rates of change occurring at different ages and stages. Because ‘children are not little adults’, it’s been difficult to define clinically-important changes in weight status in response to weight management interventions….until recently, that is.

A new paper by Reinehr et al. showed that intervention-mediated reductions in BMI SDS (z-score) of >0.25 and >0.50 in children (n~1,400) classified as overweight or obese led to meaningful improvements in blood pressure, triglycerides, and HDL-C, all of which are common cardiometabolic risk factors associated with obesity. The study was notable in the high sample size, high degree of intervention engagement, and low attrition. The authors have reported previously that improvements in quality of life can occur at thresholds below these cut-offs (see HERE). Collectively, these data highlight that if clinicians, researchers, and families want to set a weight loss goal for children with obesity, a goal that is linked to improved health outcomes in response to weight management, achieving a BMI SDS reduction >0.25 represents an evidence-based goal.

GB

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