{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T06:19:42Z","timestamp":1792045182170,"version":"4.4.0"},"reference-count":45,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2023,8,6]],"date-time":"2023-08-06T00:00:00Z","timestamp":1691280000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Obesity"],"published-print":{"date-parts":[[2023,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>The first\u2010line approach for childhood obesity is lifestyle intervention (LI); however, success varies. This study\u00a0aimed first to identify distinct subgroups of response in children living with overweight and obesity and second to elucidate predictors for subclusters.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Based on the obesity patient follow\u2010up registry the APV (Adipositas\u2010Patienten\u2010Verlaufsdokumentation) initiative, a total of 12,453 children and adolescents (median age: 11.5 [IQR: 9.7\u201313.2] years; BMI <jats:italic>z<\/jats:italic> score [BMIz]: 2.06 [IQR: 1.79\u20132.34]; 52.6% girls) living with overweight\/obesity and participating in outpatient LI were studied. Longitudinal k\u2010means clustering was used to identify individual BMIz response curve for up to 2\u2009years after treatment initiation. Multinomial logistic regression was used to elucidate predictors for cluster membership.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 36.3% of children and adolescents experienced \u201cno BMIz loss.\u201d The largest subcluster (44.8%) achieved \u201cmoderate BMIz loss,\u201d with an average delta\u2010BMIz of \u22120.23 (IQR: \u22120.33 to \u22120.14) at study end. A total of 18.9% had a \u201cpronounced BMIz loss\u201d up to \u22120.61 (IQR: \u22120.76 to \u22120.49). Younger age and lower BMIz at LI initiation, larger initial BMIz loss, and less social deprivation were linked with higher likelihood for moderate or pronounced BMIz loss compared with the no BMIz loss cluster (all <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>These results support the importance of patient\u2010tailored intervention and earlier treatment escalation in high\u2010risk individuals who have little chance of success.<\/jats:p><\/jats:sec>","DOI":"10.1002\/oby.23844","type":"journal-article","created":{"date-parts":[[2023,8,7]],"date-time":"2023-08-07T06:54:51Z","timestamp":1691391291000},"page":"2375-2385","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Who benefits most from outpatient lifestyle intervention? An <scp>IMI\u2010SOPHIA<\/scp> study on pediatric individuals living with overweight and obesity"],"prefix":"10.1002","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7570-9095","authenticated-orcid":false,"given":"Nicole","family":"Prinz","sequence":"first","affiliation":[{"name":"Institute of Epidemiology and Medical Biometry, Central Institute for Biomedical Technology University of Ulm  Ulm Germany"},{"name":"German Center for Diabetes Research  Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9245-4576","authenticated-orcid":false,"given":"Hugo","family":"Pomares\u2010Millan","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences Malm\u00f6 Lund University Diabetes Centre, Lund University  Malm\u00f6 Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Almut","family":"Dannemann","sequence":"additional","affiliation":[{"name":"Sana Klinikum Lichtenberg  Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe N.","family":"Giordano","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences Malm\u00f6 Lund University Diabetes Centre, Lund University  Malm\u00f6 Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christine","family":"Joisten","sequence":"additional","affiliation":[{"name":"Department for Physical Activity in Public Health Institute of Movement and Neurosciences, German Sport University Cologne  Cologne Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antje","family":"K\u00f6rner","sequence":"additional","affiliation":[{"name":"Medical Faculty, Hospital for Children and Adolescents, Center for Pediatric Research Leipzig University  Leipzig Germany"},{"name":"Helmholtz Institute for Metabolic, Obesity and Vascular Research of the Helmholtz Zentrum M\u00fcnchen at the University of Leipzig and University Hospital Leipzig  Leipzig Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Weghuber","sequence":"additional","affiliation":[{"name":"Department of Pediatrics University Hospital Salzburg, Paracelsus Medical University  Salzburg Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susann","family":"Weihrauch\u2010Bl\u00fcher","sequence":"additional","affiliation":[{"name":"Department for Pediatrics I, Pediatric Endocrinology University Hospital Halle\/Saale  Halle Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susanna","family":"Wiegand","sequence":"additional","affiliation":[{"name":"Charit\u00e9 \u2013 Universit\u00e4tsmedizin Berlin, corporate member of Freie Universit\u00e4t Berlin and Humboldt\u2010Universit\u00e4t zu Berlin, Sozialp\u00e4diatrisches Zentrum  Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reinhard W.","family":"Holl","sequence":"additional","affiliation":[{"name":"Institute of Epidemiology and Medical Biometry, Central Institute for Biomedical Technology University of Ulm  Ulm Germany"},{"name":"German Center for Diabetes Research  Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefanie","family":"Lanzinger","sequence":"additional","affiliation":[{"name":"Institute of Epidemiology and Medical Biometry, Central Institute for Biomedical Technology University of Ulm  Ulm Germany"},{"name":"German Center for Diabetes Research  Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"the APV initiative and the Stratification of Obesity Phenotypes to Optimize Future Therapy (SOPHIA) consortium","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,8,6]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1159\/000441483"},{"issue":"1","key":"e_1_2_11_3_1","first-page":"16","article-title":"Overweight and obesity among children and adolescents in Germany. 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