EVALUATION OF THE SICKKIDS TEAM OBESITY MANAGEMENT PROGRAM (STOMP)

Program: Abstracts - Orals, Featured Poster Presentations, and Posters
Session: MON 695-707-Obesity Treatment
Clinical
Monday, June 17, 2013: 1:45 PM-3:45 PM
Expo Halls ABC (Moscone Center)

Poster Board MON-704
Paola D Luca*, Elizabeth Dettmer, Preeti Grewal, Brian W McCrindle, Catherine S Birken and Jill K Hamilton
The Hospital for Sick Children, Toronto, ON, Canada
Background: The effectiveness of real-world clinical lifestyle programs to treat childhood obesity is unclear. The SickKids Team Obesity Management Program (STOMP) is a 2 yr tertiary care lifestyle program for adolescents 12-17 yrs with severe obesity (BMI >99th percentile for age and gender or BMI >95th percentile with an obesity-related co-morbidity or co-existing chronic illness). The interdisciplinary STOMP team provides medical management of co-morbidities, nutrition and exercise counseling, cognitive behavioural therapy and motivational interviewing.

Objectives: To evaluate the STOMP program by comparing anthropometric, metabolic, healthy behaviour changes and psychosocial outcomes in STOMP patients vs. a comparison group of obese adolescents not participating in STOMP at 6 months.

Methods: A case-comparison study design was used. 75 patients enrolled in STOMP were compared to 41 comparison participants who met criteria for referral to STOMP but were not in the program. Outcomes were measured at baseline and 6 months. Attrition rates at 6 months for the treatment and comparison group were 13% and 15% respectively.

Results: At baseline, STOMP patients had a mean BMI of 44.8±7.8 kg/m2 and a mean age of 15.1 yrs; 65% were female. The comparison participants had a mean BMI of 34.5±8 kg/m2 and a mean age of 14.9 yrs; 58% were female. STOMP patients were significantly more obese and had significantly worse cardio-metabolic and quality of life (QOL) measures at baseline vs. the comparison group. Preliminary 6 month results demonstrated a significant improvement in BMI in STOMP patients vs. comparison participants (treatment effect -1.0 kg/m2, p=0.01). Homeostatic model assessment-insulin resistance (HOMA-IR) and scores on the Children’s Depression Inventory (CDI) improved in STOMP patients vs. comparison participants (D HOMA-IR -1.4±6.5 vs. 1.5±4.3; p=0.04 and D CDI -3.9±9.7 vs. 0.1±6.3; p=0.05). At 6 months, STOMP patients showed a significant improvement in scores on the Pediatric QOL (Emotional, School, Psychosocial Health Summary and Total subscales), Impact of Weight on Quality of Life (IWQOL)-Kids (Physical Comfort, Body Esteem and Total subscales) and CDI questionnaires compared to baseline (p=0.001-0.03). The comparison group demonstrated an increase in BMI (0.7±1.5; p=0.008), systolic blood pressure (5.1±10.9; p=0.01) and HOMA-IR (1.5±4.3; p=0.01), and an improvement on the IWQOL-Kids Total subscale (3±10.4; p=0.04) compared to baseline.

Conclusions: Participation in the STOMP program resulted in significant improvements in BMI, insulin resistance and depression scores vs. a comparison group at 6 months. Evaluation of clinical lifestyle programs is essential to understanding real-world outcomes for adolescent participants. In addition to changes in BMI, changes in cardio-metabolic and QOL measures are important and clinically relevant factors to evaluate.

Nothing to Disclose: PDL, ED, PG, BWM, CSB, JKH

*Please take note of The Endocrine Society's News Embargo Policy at http://www.endo-society.org/endo2013/media.cfm