TOPLINE:

Lower obesity-related quality of life (QOL) in adolescents was independently associated with greater motivation to participate in a pediatric weight management program among adolescents and their caretakers, whereas in children, lower obesity-related QOL and a higher BMI SD score increased caretaker willingness to participate in such a program.

METHODOLOGY:

• Pediatric weight management programs often have modest effects and high dropout rates, partly due to low motivation among participating families. Readiness to change (RTC) is a measure of motivation to change specific behaviors and is especially relevant before families begin a pediatric weight management program.
• Researchers conducted a cross-sectional analysis of baseline data from the trial of the STARKIDS program (a family-based weight management program for overweight and obesity in youth) to identify determinants of RTC in children and adolescents aged 3-17 years with BMI > 90th percentile and their caretakers (mostly family).
• The current study involved 125 adolescents aged 12 years or older (mean age, 14.13 years; 40% girls), 185 caretakers of adolescents (mean age, 43.02 years; 88% women), and 325 caretakers of children aged 11 years or younger (mean age, 39.18 years; 88.6% women).
• Potential determinants included sociodemographic variables, weight, general and obesity-related QOL, self-efficacy, and body image, collected via questionnaires. Obesity-related and general QOL were self-reported by adolescents and proxy-reported for children and adolescents by their caregivers using the KINDL-R questionnaire.
• RTC was calculated using a self-report questionnaire on the basis of the transtheoretical model (a theory explaining behavior change), with higher scores indicating greater motivation.

TAKEAWAY:

• In adolescents, a lower obesity-related QOL was associated with higher RTC (beta-coefficient, -0.31; P = .002), reflecting that a lower obesity-specific QOL is tied to greater motivation to participate in a weight management program.
• In caretakers of adolescents, a proxy-reported lower obesity-related QOL was associated with a higher caretaker RTC (beta-coefficient, -0.44; P < .001).
• For caretakers of children, proxy-reported lower obesity-related QOL (beta-coefficient, -0.22; P = .001) and higher children’s BMI SD score (beta-coefficient, 0.16; P = .005) independently predicted higher caretaker RTC.

IN PRACTICE:

“Clinicians should work with the whole family, strengthen their collaboration, and pay special attention to the OB [obesity]-related QOL of the affected children and adolescents,” the authors of the study wrote.

SOURCE:

The study, led by Anne Herschbach, University Hospital Tübingen, Tübingen, Germany, was published online in Obesity.

LIMITATIONS:

Participating in a weight management program already indicates some motivation, which may have introduced selection bias. The enrolled children and adolescents had very high mean BMI percentiles, so the findings likely reflected families at the more severe end of the obesity spectrum. Because no data were collected on families who dropped out before assessments, the risk for attrition bias remained unclear. Finally, the cross-sectional design precluded causal inferences.

DISCLOSURES:

The STARKIDS project is funded by the Innovation Committee of the German Joint Federal Committee. Part of this work has been funded by the EU’s Horizon Europe Research and Innovation Programme. The authors reported having no conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.