Don’t judge an obesity intervention by BMI alone

August 20, 2013

Body mass index (BMI) or degree of change in BMI is insufficient when it comes to evaluating the success or failure of obesity interventions in children, finds a new study.

Body mass index (BMI) or degree of change in BMI is insufficient when it comes to evaluating the success or failure of obesity interventions in children, finds a new study.

In fact, the researchers, who are from the United Kingdom, say that using any single parameter as a yardstick by which to gauge the value of an obesity intervention is overly restrictive and may lead to overlooking other indicators of positive change, such as increased cardiovascular fitness.

The researchers began by studying 79 obese children. They applied the Mind, Exercise, Nutrition . . . Do it! (MEND) childhood obesity intervention and then looked at changes in zBMI, waist circumference, cardiovascular fitness, physical and sedentary activities, and self-esteem at 6 months and again at 12 months. At 12 months, 42 children remained in the study.

The investigators found that other than waist circumference and its z-score, no differences or trends across zBMI subgroups existed for any outcome. Benefits in several parameters occurred in the children who participated in the intervention regardless of the degree of zBMI change.

The researchers concluded that health benefits can result from an intervention independent of weight change and should not be overlooked or underestimated.

The American Academy of Child and Adolescent Psychiatry (AACAP) reports that up to one-third of American children and teenagers are obese. Childhood obesity increases the risk for everything from cardiovascular disease and diabetes to emotional problems. Visit the AACAP Web site to download a printable fact page for your patients and their families. 

To get weekly clinical advice for today's pediatrician, subscribe to the Contemporary Pediatrics eConsult.