{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T08:59:29Z","timestamp":1790845169727,"version":"4.1.0"},"reference-count":35,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T00:00:00Z","timestamp":1789516800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T00:00:00Z","timestamp":1789516800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100002322","name":"Coordena\u00e7\u00e3o de Aperfei\u00e7oamento de Pessoal de N\u00edvel Superior","doi-asserted-by":"publisher","award":["88887.637569\/2021\u201000"],"award-info":[{"award-number":["88887.637569\/2021\u201000"]}],"id":[{"id":"10.13039\/501100002322","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Obesity Science &amp;amp; Practice"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      Childhood obesity remains a major public health challenge, and evidence on the outcomes of routine multidisciplinary care in real\u2010world clinical settings remains limited. This study evaluated longitudinal changes in BMI\n                      <jats:italic>z<\/jats:italic>\n                      \u2010score and lifestyle behaviors among children and adolescents with obesity and their caregivers receiving standard multidisciplinary care, and examined the association between caregiver and pediatric BMI over a 6\u2010month follow\u2010up period.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This observational study included 111 caregiver\u2013child dyads (children aged 8\u201316\u00a0years) attending a tertiary public outpatient clinic. Participants received routine multidisciplinary care, including an initial multidisciplinary education session followed by consultations with pediatricians, nutritionists, and physical educators. Assessments were conducted at baseline, 3\u00a0months, and 6\u00a0months, and included anthropometric, body composition, behavioral, and clinical measures. Longitudinal analyses and correlation tests were performed to examine changes over time and associations between caregivers and pediatric BMI.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Children showed a modest reduction in BMI\n                      <jats:italic>z<\/jats:italic>\n                      \u2010score at 3\u00a0months (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      \u00a0=\u00a0\u22120.1,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.007), which was not maintained at 6\u00a0months (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      \u00a0=\u00a0\u22120.04,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.069). No significant changes in dietary or physical activity behaviors were observed. Caregiver measures remained stable throughout follow\u2010up. Moderate caregiver\u2013child BMI correlations were observed across all time points (\n                      <jats:italic>\u03c1<\/jats:italic>\n                      \u00a0=\u00a00.274,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.004;\n                      <jats:italic>\u03c1<\/jats:italic>\n                      \u00a0=\u00a00.304,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.002). Among participants with complete data, 49.5% were classified as responders, with younger participants more likely to achieve clinical improvement.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      In this real\u2010world setting, routine multidisciplinary care was associated with modest improvements in pediatric BMI\n                      <jats:italic>z<\/jats:italic>\n                      \u2010score, while caregiver measures remained stable and caregiver\u2013child BMI associations persisted over time.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/osp4.70192","type":"journal-article","created":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T05:41:54Z","timestamp":1789623714000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Family Dynamics and Longitudinal Trends in Pediatric Obesity: A Real\u2010World Observational Study in a Public Outpatient Clinic"],"prefix":"10.1002","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5368-1503","authenticated-orcid":false,"given":"F\u00e1bio","family":"de Freitas","sequence":"first","affiliation":[{"name":"Department of Pediatrics Unicamp School of Medical Sciences  Campinas S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mirella Menaque","family":"da Paz","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Unicamp School of Medical Sciences  Campinas S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariana R.","family":"Zago","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Unicamp School of Medical Sciences  Campinas S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcia Regina","family":"Vitolo","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Unicamp School of Medical Sciences  Campinas S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria \u00c2ngela","family":"Ant\u00f4nio","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Unicamp School of Medical Sciences  Campinas S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria \u00c2ngela Bellomo","family":"Brand\u00e3o","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Unicamp School of Medical Sciences  Campinas S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,16]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140\u20106736(23)02750\u20102"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2213\u20108587(22)00047\u2010X"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/obr.12334"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12889\u2010020\u201009988\u20105"},{"issue":"10","key":"e_1_2_12_6_1","first-page":"993","article-title":"Controlling Childhood Obesity: A Systematic Review on Strategies and Challenges","volume":"19","author":"Kelishadi R.","year":"2014","journal-title":"Journal of Research in Medical Sciences"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/phn.13508"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pmedr.2022.101999"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.k2486"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2023.8061"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.3390\/nu13093227"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41366\u2010020\u20100604\u20109"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.3390\/healthcare12202048"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.orcp.2020.09.002"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1210\/er.2017\u201000111"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph17114099"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140\u20106736(07)61602\u2010X"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jada.2008.01.002"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.2471\/BLT.07.043497"},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pedhc.2017.03.001"},{"key":"e_1_2_12_21_1","volume-title":"Manual de Orienta\u00e7\u00e3o: Obes Idade Na Inf\u00e2ncia e Adolesc\u00eancia","author":"Sociedade Brasileira de Pediatria","year":"2019"},{"key":"e_1_2_12_22_1","volume-title":"Guia Alimentar Para a Popula\u00e7\u00e3o Brasileira","author":"Brasil. 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