2609005236
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A Clinically Interpretable Machine Learning Framework for Knowledge Discovery and Early Outcome Prediction in Pediatric Obesity Intervention

  • Lichuan Liu 1,*,   
  • Beth Moxley 2,   
  • Nicole Klinkhamer 3

Received: 10 Jul 2026 | Revised: 08 Sep 2026 | Accepted: 20 Sep 2026 | Published: 30 Sep 2026

Abstract

Pediatric obesity remains a major public health challenge, yet substantial variability in treatment response limits the effectiveness of standardized intervention programs. Early assessment of short-term weight-change trajectories may provide useful information during an intervention. This study presents a clinically interpretable machine learning framework for predicting short-term pediatric obesity intervention outcomes using routinely collected demographic, anthropometric, body-composition, and early-response measurements from the ProActive Kids program. A systematic workflow including data understanding, clinical data preprocessing, feature engineering, and predictive modeling is developed. Three complementary machine learning paradigms, Logistic Regression, Random Forest, and Extreme Gradient Boosting (XGBoost), are comparatively evaluated to investigate predictive performance and feature importance. Baseline prediction models demonstrate limited predictive performance using only pre-intervention measurements, whereas incorporation of Week-3 early-response information substantially improves prediction across all three classifiers. Week-3 percentage weight change emerges as the dominant predictor of the Week-8 weight-reduction outcome. Waist-to-Hip Ratio, Body Fat Percentage, Body Mass Index, and Fat-Free Mass are also identified as influential baseline variables, although their individual importance should be interpreted cautiously because of correlations among anthropometric and body-composition measures. These findings demonstrate that machine learning can support short-term outcome prediction while identifying potentially clinically relevant patterns in routinely collected pediatric obesity data. The results highlight the predictive importance of early intervention response and may inform future studies of pediatric obesity intervention outcomes.

References 

  • 1.

    Noiman, A.; Saif, N.; Afful, J. Prevalence of Overweight, Obesity, and Severe Obesity among Children and Adolescents Aged 2–19 Years: United States, 1963–1965 through August 2021–August 2023. Available online: https://doi.org/10.15620/cdc/174645, (accessed on 5 July 2026).

  • 2.

    Hampl, S.E.; Hassink, S.G.; Skinner, A.C.; et al. Clinical Practice Guideline for the Evaluation and Treatment of Children and Adolescents with Obesity. Pediatrics 2023, 151, e2022060640. https://doi.org/10.1542/peds.2022-060640.

  • 3.

    US Preventive Services Task Force. Interventions for High Body Mass Index in Children and Adolescents: US Preventive Services Task Force Recommendation Statement. JAMA 2024, 332, 226–232. https://doi.org/10.1001/jama.2024.11146.

  • 4.

    Barlow, S.E. Expert Committee Recommendations regarding the Prevention, Assessment, and Treatment of Child and Adolescent Overweight and Obesity: Summary Report. Pediatrics 2007, 120, S164–S192. https://doi.org/10.1542/peds.2007-2329c.

  • 5.

    Moxley, E.; Habtzghi, D.; Klinkhamer, N.; et al. Prevention and Treatment of Pediatric Obesity: A Strategy Involving Children, Adolescents and the Family for Improved Body Composition. J. Pediatr. Nurs. 2019, 45, 13–19. https://doi.org/10.1016/j.pedn.2018.12.010.

  • 6.

    O’Connor, E.A.; Evans, C.V.; Henninger, M.; et al. Interventions for Weight Management in Children and Adolescents: Updated Evidence Report and Systematic Review for the US Preventive Services Task Force. JAMA 2024, 332, 233–248. https://doi.org/10.1001/jama.2024.6739.

  • 7.

    Fayyaz, H.; Gupta, M.; Perez Ramirez, A.; et al. An Interoperable Machine Learning Pipeline for Pediatric Obesity Risk Estimation. In Proceedings of the 4th Machine Learning for Health Symposium, Vancouver, BC, Canada, 15–16 December 2024; pp. 308–324.

  • 8.

    Chun, D.; Rhie, Y.J.; Sawyer, J.; et al. Machine Learning Prediction of Obesity Development in Children with Overweight Using Longitudinal Body Composition Data. Pediatr. Obes. 2026, 21, e70105. https://doi.org/10.1111/ijpo.70105.

  • 9.

    Zhu, H.; Zhou, M.; Liu, G.; et al. NUS: Noisy-Sample-Removed Undersampling Scheme for Imbalanced Classification and Application to Credit Card Fraud Detection. IEEE Trans. Comput. Soc. Syst. 2024, 11, 1793–1804. https://doi.org/10.1109/tcss.2023.3243925.

  • 10.

    Li, H.; Hu, G.; Li, J.; et al. Intelligent Fault Diagnosis for Large-Scale Rotating Machines Using Binarized Deep Neural Networks and Random Forests. IEEE Trans. Autom. Sci. Eng. 2022, 19, 1109–1119. https://doi.org/10.1109/tase.2020.3048056.

  • 11.

    Lim, H.; Lee, H.; Kim, J. A Prediction Model for Childhood Obesity Risk Using the Machine Learning Method: A Panel Study on Korean Children. Sci. Rep. 2023, 13, 10122. https://doi.org/10.1038/s41598-023-37171-4.

  • 12.

    Gupta, M.; Eckrich, D.; Bunnell, H.T.; et al. Reliable Prediction of Childhood Obesity Using Only Routinely Collected EHRs May Be Possible. Obes. Pillars 2024, 12, 100128. https://doi.org/10.1016/j.obpill.2024.100128.

  • 13.

    Zhou, M.C. Artificial Intelligence and Automation for Better Life of Human Beings. J. Artif. Intell. Autom. 2026, 1, 7. https://doi.org/10.53941/jaia.2026.100007.

  • 14.

    Pedregosa, F.; Varoquaux, G.; Gramfort, A.; et al. Scikit-Learn: Machine Learning in Python. J. Mach. Learn. Res. 2011, 12, 2825–2830. https://doi.org/10.5555/1953048.2078195.

  • 15.

    Gaucherot, A.; Beraud, D.; Lonjou, P.; et al. Identification of Weight Loss Predictors Using Machine Learning Approaches in Adolescents with Obesity. Pediatr. Res. 2026. https://doi.org/10.1038/s41390-026-05359-9.

  • 16.

    Gou, H.; Song, H.; Tian, Z.; et al. Prediction Models for Children/Adolescents with Obesity/Overweight: A Systematic Review and Meta-Analysis. Prev. Med. 2024, 179, 107823. https://doi.org/10.1016/j.ypmed.2023.107823.

  • 17.

    Wells, J.C.K. The Evolution of Human Body Composition. Proc. Nutr. Soc. 2012, 71, 593–602.

  • 18.

    Bishop, C.M. Pattern Recognition and Machine Learning; Springer: New York, NY, USA, 2006. https://doi.org/10.1007/978-0-387-45528-0.

  • 19.

    Hosmer, D.W.; Lemeshow, S.; Sturdivant, R.X. Applied Logistic Regression, 3rd ed.; John Wiley & Sons, Inc.: Hoboken, NJ, USA, 2013. https://doi.org/10.1002/9781118548387.

  • 20.

    Bhupathiraju, S.N.; Hu, F.B. Epidemiology of Obesity and Diabetes and Their Cardiovascular Complications. Circ. Res. 2016, 118, 1723–1735. https://doi.org/10.1161/circresaha.115.306825.

  • 21.

    Breiman, L. Random Forests. Mach. Learn. 2001, 45, 5–32. https://doi.org/10.1023/a:1010933404324.

  • 22.

    Chen, T.; Guestrin, C. XGBoost: A Scalable Tree Boosting System. In Proceedings of the KDD ’16: The 22nd ACM SIGKDD International Conference on Knowledge Discovery and Data Mining, San Francisco, CA, USA, 13–17 August 2016; pp. 785–794. https://doi.org/10.1145/2939672.2939785.

  • 23.

    Tjoa, E.; Guan, C. A Survey on Explainable Artificial Intelligence (XAI): Toward Medical XAI. IEEE Trans. Neural Netw. Learn. Syst. 2021, 32, 4793–4813. https://doi.org/10.1109/tnnls.2020.3027314.

  • 24.

    Liu, H.; Leng, Y.; Wu, Y.C.; et al. Robust Identification Key Predictors of Short- and Long-Term Weight Status in Children and Adolescents by Machine Learning. Front. Public Health 2024, 12, 1414046. https://doi.org/10.3389/fpubh.2024.1414046.

  • 25.

    Gan, Q.; Han, J; Vitiello, D. Determinants of Childhood and Adolescent Obesity: An Explainable AI Approach Using the ICAD Database. Public Health 2026, 257, 106366. https://doi.org/10.1016/j.puhe.2026.106366.

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Liu, L.; Moxley, B.; Klinkhamer, N. A Clinically Interpretable Machine Learning Framework for Knowledge Discovery and Early Outcome Prediction in Pediatric Obesity Intervention. Journal of Artificial Intelligence for Automation 2026, 1 (2), 14. https://doi.org/10.53941/jaia.2026.100014.
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