1. Severity of Obesity and Six-Month Outcomes among Youth in Pediatric Weight Management: POWER Retrospective Cohort Study 2009-2010 B Sweeney, MD 1 ; E King, PhD 2 ; E Rhodes, MD, MPH 3 ; J Tucker, PhD 4 ; M Grow, MD, MPH 5 ; M Mietus-Snyder, MD 6 ; L Lostocco, MSN, RN 7 ; G Datto, MD 8 ; E Estrada, MD 9 ; CB Jasik, MD 10 ; I Eneli, MD 11 ; W Stratbucker, MD 4 ; S Woolford, MD, MPH 12 ; and S Kirk, PhD, RD, LD 2 Background Previous studies of individual multi-component pediatric weight management (PWM) programs reported modest improvements in body mass index (BMI) among youth with obesity. 1 This retrospective cohort study formed the foundation for the ongoing prospective POWER project. Methods The study sample included 5756 patients ages 2- 18 with 3605 (63%) children having one or more follow-up visits over 6 months (see Table ). Chi-square and multivariable ANOVA were conducted. Programmatic success, defined as change in BMI (% of the 95 th percentile) less than 0, was evaluated for patients with one or more follow-up visits over a 6 month period. 3 Objective The Pediatric Obesity Weight Evaluation Registry (POWER) is a multi-site U.S. data registry that provides a larger aggregate patient population to evaluate health outcomes in PWM programs across the country. 2 This retrospective cohort study evaluated 6- month change in BMI and examined moderating factors (i.e. demographics, obesity severity) among youth with obesity participating in PWM at 9 POWER sites from 2009-2010. 1 Children’s Mercy Hospitals and Clinics, Kansas City, MO; 2 Cincinnati Children's Hospital, Cincinnati, OH; 3 Boston Children's Hospital, Boston, MA; 4 Helen DeVos Children's Hospital, Grand Rapids, MI; 5 Seattle Children's Hospital, Seattle, WA; 6 Children's National Health System, Washington, DC; 7 Children's Hospital Association, Alexandria, VA; 8 Nemours/Alfred I. duPont Hospital for Children, Wilmington, DE; 9 University of North Carolina at Chapel Hill; 10 UCSF Benioff Children's Hospital, San Francisco, CA; 11 Nationwide Children’s Hospital, Columbus, OH; 12 C.S. Mott Children's Hospital, Ann Arbor, MI References 1. Woolford SJ, Sallinen BJ, Clark SJ, Freed GL. Results from a clinical multidisciplinary weight management program. Clin Pediatr. 2011;50(3):187-191. 2.Jasik CB, King EC, Rhodes E, et al. Characteristics of Youth Presenting for Weight Management: Retrospective National Data from the POWER Study Group. Childhood Obesity. Oct 2015;11(5):630-637. 3.Skinner AC, Skelton JA. Prevalence and trends in obesity and severe obesity among children in the United States, 1999-2012. JAMA Pediatrics. Jun 2014;168(6):561-566. Results Table. Patients with Follow-up Visits N3605 Age (years)11.8 ± 3.5 Sex: n (% female)1980 (55%) Race: n (%) Black992 (28%) White1856 (52%) Other/Unknown757(20%) Ethnicity: n (%) Hispanic739 (21%) Insurance Coverage: n (%) Public1890 (53%) Private1607 (45%) Self-pay100 (3%) Weight status: n (%) Obesity921 (26%) Severe Obesity - Class 21292 (36%) Severe Obesity - Class 31392 (38%) Obesity: BMI 100-120% of the 95th percentile and BMI < 35 whichever is lower Severe Obesity Class 2: BMI 121-140% of the 95th percentile or BMI = 35-39, whichever is lower Severe Obesity Class 3: BMI > 140% of the 95th percentile or BMI > 40 kg/m2, whichever is lower Conclusions 64% of patients had programmatic success and decreased BMI percent of the 95 th percentile. Multi-component PWM programs across the country can be effective in the short term for the majority of youth with obesity regardless of the extent of obesity at presentation. Figure 3. Percent of cohort with Programmatic Success More patients with SOB3 maintained or decreased BMI percent when they came to more than one FV (68% vs 59%, p<0.001) Over 6 months, 36% of patients had 1 follow-up visit and 64% had more than one follow-up visit. Figure 2. Mean Change in % of the 95 th Percentile Youth 6-11 yo had more improvement in BMI % of the 95 th percentile change (-2.9 +-0.5) than 2-5 yo (-0.45 +- 0.7, p=001) and 15-17 yo (-1.6 +- 0.6, p=0.02) Figure 1. Percent of the 95 th Percentile BMI % of the 95 th percentile change was greater among SOB3 (-3.5 +- 0.5) than SOB2 (-1.2 +- 0.5) and OB (-0.5 +- 0.5) (all p<0.0001)