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 to 12 years. Mixed‐effects regression models compared children who participated in a 12‐month weight‐management intervention before versus during the COVID‐19 pandemic on change from baseline in BMI z score (ΔzBMI) at 3, 6, 9, and 12 months. Results The observed pattern of ΔzBMI was significantly different before versus during the pandemic (χ2 = 22.73, p < 0.0001). 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 < 0.0001). Treatment session completion did not differ before versus during the pandemic (60.4% vs. 55.7%, respectively; p = 0.30) 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.