LAUSR

Obesity is a health epidemic affecting 19% of the youth in the United States [1]. Family-based lifestyle modifications [2], and multidisciplinary care have been most effective in treating this multigenerational disease [3]. Our group has previously demonstrated that multidisciplinary weight management (MDM) in pediatric participants at an urban program between 2014 and 2017 resulted in the reversal of the Body Mass Index z-score changes (z-BMI Δ) when were compared longitudinally to routine pediatric care before MDM intervention [4]. Despite successes in weight management, large attrition of the participants’ follow-up was noted, similar to those reported in MDM programs for adult participants [5, 6]. The participants who fail follow-up possibly included nonresponders who self-selected to optout. Therefore, follow-up attrition is very concerning and strategies to improve adherence are needed. Contrary to clinical practice, most protocol-based clinical trials and research studies have a predetermined follow-up duration and much higher participant follow-up [2, 7]. We hypothesized that a predefined structured follow-up with an “end date” will improve individual participation and adherence to MDM clinical visits while maintaining improvements in weight and metabolic markers. The overarching objective was to develop strategies to improve participant adherence in routine clinical settings that could be mirrored in future longer clinical studies.