Family Dynamics and Longitudinal Trends in Pediatric Obesity: A Real‐World Observational Study in a Public Outpatient Clinic

ABSTRACT Background Childhood obesity remains a major public health challenge, and evidence on the outcomes of routine multidisciplinary care in real‐world clinical settings remains limited. This study evaluated longitudinal changes in BMI z ‐score 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‐month follow‐up period. Methods This observational study included 111 caregiver–child dyads (children aged 8–16 years) 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 months, and 6 months, 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. Results Children showed a modest reduction in BMI z ‐score at 3 months ( β = −0.1, p = 0.007), which was not maintained at 6 months ( β = −0.04, p = 0.069). No significant changes in dietary or physical activity behaviors were observed. Caregiver measures remained stable throughout follow‐up. Moderate caregiver–child BMI correlations were observed across all time points ( ρ = 0.274, p = 0.004; ρ = 0.304, p = 0.002). Among participants with complete data, 49.5% were classified as responders, with younger participants more likely to achieve clinical improvement. Conclusions In this real‐world setting, routine multidisciplinary care was associated with modest improvements in pediatric BMI z ‐score, while caregiver measures remained stable and caregiver–child BMI associations persisted over time.