The aim of the study is to assess the effectiveness of lifestyle modification (LM) recommendations delivered in routine outpatient clinics for children/ adolescents with overweight/obesity and to explore factors associated with response. A total of 99 patients aged 5–18 years with exogenous overweight/ obesity followed for ≥6 months (2021–2023) were reviewed retrospectively. Patients were classified as responders (LM+) if BMI z-score decreased by ≥5% at 6 months, and non-responders (LM–) otherwise. BMI z-score decreased at 6 months (p=0.011; Cohen’s d=0.26). Overall, 30.6% were LM+, and 8% of those with obesity shifted to overweight. At baseline, insulin resistance, dyslipidemia, hepatic steatosis, and elevated blood pressure were present in 63.3%, 54.3%, 55.3%, and 50% of patients, respectively. Baseline anthropometric and metabolic parameters were similar between LM+ and LM– groups. Routine LM recommendation achieved meaningful weight control in a minority of patients despite a high burden of comorbidities. Since responders and nonresponders were not distinguishable by baseline measures, implementing high-intensity, family-centered, multidisciplinary programs may be necessary to improve outcomes in pediatric overweight/obesity.

Keywords: pediatric, exogenous obesity, overweight, lifestyle modification, weight management