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Impact of Race and Ethnicity on Weight-Loss Outcomes in Pediatric Family-Based Obesity Treatment

Abstract

Introduction

Minority children are disproportionately affected by obesity and little is known about how race/ethnicity impacts outcomes in pediatric weight-loss treatment. This study aimed to evaluate whether race/ethnicity affected weight-loss outcomes in a pediatric obesity intervention. Secondary aims included evaluating whether race/ethnicity was associated with energy intake, exercise, program adherence, acceptability, and attendance.

Methods

One hundred fifty parent/child dyads (age 8–12 years, BMI% 85–99.9; 32% Hispanic, 24% Non-Hispanic, Non-White, 44% Non-Hispanic White) participated in a randomized control trial evaluating weight loss in family-based behavioral treatment with (FBT) or without child participation (i.e., Parent-Based Treatment, PBT). Assessments occurred at baseline, mid-treatment (month 3), post-treatment (month 6), and follow-up (months 12 and 24). Analyses included linear mixed effect models, linear models, and a negative binomial model.

Results

Weight loss in Hispanic, Non-Hispanic White, and Non-Hispanic, Non-White children was not significantly different by race/ethnicity at months 6, 12, and 24 (p = 0.259) and was similar across both treatments (FBT = − 0.16 BMIz; PBT = − 0.21 BMIz; p = 0.61). There were no differences in energy intake, physical activity, acceptability ratings, or adherence to treatment (as measured by a post-treatment survey) (p’s > 0.123). However, Hispanic families attended fewer treatment visits than Non-Hispanic White families (p = 0.017).

Conclusion

On average, children lost weight participating in our pediatric obesity treatment and there was no statistical difference in weight loss between groups. Future research evaluating whether culturally adapted treatments would be more effective for racial/ethnic minorities or whether the personalization inherent in family-based behavioral treatment may be sufficient is needed.

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Acknowledgments

The authors would like to thank the families who participated in this research as well as the UCSD CHEAR staff members who made this all possible. Data will be made available summarized in this publication may be available in a deidentified format to investigators for research purposes following approval from the principal investigators.

Funding

This study was supported by the National Institutes of Health under grants: R01DK075861, K23DK114480, and K02HL112042. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Author information

Correspondence to Dawn M. Eichen.

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Conflict of Interest

The authors declare that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional review boards at University of California San Diego and Rady Children’s Hospital, San Diego and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual parents included in the study and individual assent was obtained from all individual children.

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Eichen, D.M., Rhee, K.E., Strong, D.R. et al. Impact of Race and Ethnicity on Weight-Loss Outcomes in Pediatric Family-Based Obesity Treatment. J. Racial and Ethnic Health Disparities (2020). https://doi.org/10.1007/s40615-019-00694-6

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Keywords

  • Childhood obesity
  • Family-based interventions
  • Ethnic minorities
  • Family-based treatment
  • Parent-only treatment
  • Hispanic
  • Behavioral weight loss