Purpose: Absolute weight loss may not always be the best measure of adherence and response to therapy in obese adolescents if weight gain owing to linear growth is not considered. We wished to compare short-term absolute weight and height changes with changes in body mass index (BMI) in a group of severely obese adolescents to determine the most meaningful measure of treatment response.
Methods: We analyzed weight, height, and BMI in 27 adolescents, 10-18 years of age, referred for management of severe obesity. Subjects attended clinic on at least three occasions within a 6-24-month period. Detailed profiles of usual daily food intakes, physical activities, and family and environmental structure/activities were obtained, and specific goals to achieve weight control were negotiated with adolescents and their families at each visit. Weight, height, and BMI at the initial visit and at the most recent visit were compared.
Results: While 48% of our population actually lost weight, 78% either had no change or a decrease in BMI during the observation period. Differences between initial and most recent heights and BMIs were statistically significant, but weight changes were not significant.
Conclusions: In addition to weight, BMI should be routinely used and reported when monitoring the response to specific interventions in growing adolescents. Evaluation of weight alone may underestimate the adolescent's adherence to treatment goals.