Pathways to Eating in Children and Adolescents with Obesity

Transcription

1 Pathways to Eating in Children and Adolescents with Obesity Childhood and Adolescent Obesity Conference Ottawa, Ontario October 25, 2016 Hayyah Clairman, B.Sc. (Hons.) M.Sc. Student, Institute of Medical Science, University of Toronto Division of Endocrinology, The Hospital for Sick Children

2 Conflict of Interest I have no conflicts of interest to disclose. 2

3 Introduction & Eating Behaviours 3

4 Current Treatment + Images from: 4

5 One Size Does Not Fit All Image from: 5

6 Children with Obesity vs Non-Obese Peers (Braet & van Strien, 1997) 6

7 Children with Obesity vs Non-Obese Peers (Hoffmann et al, 2015) 7

8 Eating Mechanisms Co-occur in Children with Obesity (Reinblatt et al, 2015) 8

9 Appetite Regulation is Complex Image from: Van Vugt (2010) Brain imaging studies of appetite in the context of obesity and the menstrual cycle. Human Reproduction Update 16(3):

10 Eating Mechanisms 10

11 Objectives

12 Objectives 1) To determine the clustering properties of eating mechanisms in children and adolescents with obesity 2) To relate identified phenotypes to demographic, anthropometric, and eating environment measures 12

13 Methodology

14 Study Population Ages years English-speaking Enrolled in CIHR-funded CANPWR (Baseline or 12 month visit) 14

15 Data Collection Responses to 2 child/adolescent self-report and 2 parent-for-childreport questionnaires Questionnaires (total items: parent = 31, child = 25): EDE-Q: Loss of control eating DEBQ: Emotional, Restrained, and External Eating subscales HQ: Total hyperphagia score SWAN: Hyperactivity/Impulsivity and Inattention subscales 15

16 Analytic Plan 16

17 Cross-Sectional Analysis Objective #1: Latent Profile Analysis (LPA) Phenotypes identified using indicator variables (mechanisms) Membership assigned to latent cluster from similarities between variables Sample size of is comparable to similar analyses 17

18 Sample Model: 4 Clusters/Phenotypes Emotional- Restrained Hyperphagic Impulsive- External Distracted- Uninhibited LOSS OF CONTROL EATING EMOTIONAL EATING HYPERPHAGIA IMPULSIVITY RESPONSE TO EXTERNAL CUES INATTENTION LOSS OF CONTROL EATING RESTRAINED EATING RESPONSE TO EXTERNAL CUES 18

19 Strategies for Treatment Emotional- Restrained Hyperphagic Impulsive- External Distracted- Uninhibited LOSS OF CONTROL EATING EMOTIONAL EATING HYPERPHAGIA IMPULSIVITY RESPONSE TO EXTERNAL CUES INATTENTION LOSS OF CONTROL EATING RESTRAINED EATING RESPONSE TO EXTERNAL CUES DBT/CBT Behavioural Therapy/ Medication Mindfulness ADHD coach/ Medication for ADHD 19

20 Cross-Sectional Analysis Objective #2: Analysis of Variance (ANOVA) Clinical characteristics will be compared across phenotypes Demographics (e.g. age, sex, family structure) Anthropometrics (BMI) Eating Environment (e.g. meals with family, meals in front of TV) 20

21 Current Progress & Significance

22 Recruitment 8 CANPWR sites ~220 participants to date 300 anticipated by January

23 Significance Identifying latent phenotypes in children and adolescents with obesity will lead to increased investigation into better targeted weight-management interventions 23

24 Acknowledgements Supervisor: Dr. Jill Hamilton Sickkids STOMP Team Funding: Thesis Committee: Dr. Debra Katzman Dr. Valerie Taylor Hamilton Research Team: Kristina Cordeiro Katharine Hamilton Ping Li Shawna Steele CANPWR Investigators 24

25 Questions Image from: 25

26 Extra Slides 26

27 Recruitment Update BC Children s (Vancouver) 3 Alberta CH (Calgary) 37 Stollery CH (Edmonton) 19 McMaster (Hamilton) 61 Credit Valley (Toronto) 21 SickKids (Toronto) 53 CHEO (Ottawa) 29 Montreal CH (Montreal) 0 TOTAL