Attenuated efficacy of pediatric obesity treatment during the COVID-19 pandemic.

OBJECTIVE: This study examined whether the efficacy of a standard-of-care pediatric obesity treatment was affected by the COVID-19 pandemic. METHODS: Analyses leveraged data from an ongoing pediatric obesity treatment trial involving 230 lower-income, urban children aged 6-12 y. Mixed effects regression models compared children who participated in a 12-month weight management intervention before vs. during the COVID-19 pandemic on change from baseline in body mass index z-score (ΔzBMI) at 3, 6, 9, and 12 months. RESULTS: The observed pattern of ΔzBMI was significantly different before vs. during the pandemic (χ2 =22.73, p<.0001). Children treated before the pandemic maintained an average weight loss of -0.06 ΔzBMI at 12 months, whereas children treated during the pandemic steadily gained weight over time, averaging a net gain of 0.11 ΔzBMI at 12 months (χ2 =34.99, p<.0001). Treatment session completion did not differ before vs. during the pandemic (60.4% vs. 55.7%, respectively; p=.30), or account for differences in ΔzBMI. CONCLUSIONS: Similar reductions in intervention efficacy may be anticipated in other pediatric obesity treatment trials conducted during the COVID-19 pandemic. Many families that have struggled with managing their child's weight during this period may need encouragement to continue engaging in structured weight management as society renormalizes.