Obesity Evaluation and Treatment

Expert Committee Recommendations

Datos Bibliográficos

ID23356530
AutoresSarah E Barlow (0000-0002-1672-2126, 1 From the Division of Pediatric Gastroenterology and Nutrition, New England Medical Center, Boston, Massachusetts.), William H Dietz (0000-0002-6972-0925, 1 From the Division of Pediatric Gastroenterology and Nutrition, New England Medical Center, Boston, Massachusetts.)
Año1998
Volumen102
Número3
Páginase29-e29
Fecha de publicación1998-09-01
Peer ReviewedSí
Open AccessNo
TipoARTICLE
RevistaPEDIATRICS (JOURNAL)
Identificadores de la revistaISSN: 0031-4005 • E-ISSN: 1098-4275
EditorialAmerican Academy of Pediatrics (AAP) (PUBLISHER)
DOI10.1542/peds.102.3.e29
PMID9724677
OpenAlexW2154524666
IdiomaEN
Citas recibidas103
Referencias citadas70

OBJECTIVES: The development of recommendations for physicians, nurse practitioners, and nutritionists to guide the evaluation and treatment of overweight children and adolescents. METHODS: The Maternal and Child Health Bureau, Health Resources and Services Administration, the Department of Health and Human Services convened a committee of pediatric obesity experts to develop the recommendations. RESULTS: The Committee recommended that children with a body mass index (BMI) greater than or equal to the 85th percentile with complications of obesity or with a BMI greater than or equal to the 95th percentile, with or without complications, undergo evaluation and possible treatment. Clinicians should be aware of signs of the rare exogenous causes of obesity, including genetic syndromes, endocrinologic diseases, and psychologic disorders. They should screen for complications of obesity, including hypertension, dyslipidemias, orthopedic disorders, sleep disorders, gall bladder disease, and insulin resistance. Conditions that indicate consultation with a pediatric obesity specialist include pseudotumor cerebri, obesity-related sleep disorders, orthopedic problems, massive obesity, and obesity in children younger than 2 years of age. Recommendations for treatment evaluation included an assessment of patient and family readiness to engage in a weight-management program and a focused assessment of diet and physical activity habits. The primary goal of obesity therapy should be healthy eating and activity. The use of weight maintenance versus weight loss to achieve weight goals depends on each patient's age, baseline BMI percentile, and presence of medical complications. The Committee recommended treatment that begins early, involves the family, and institutes permanent changes in a stepwise manner. Parenting skills are the foundation for successful intervention that puts in place gradual, targeted increases in activity and targeted reductions in high-fat, high-calorie foods. Ongoing support for families after the initial weight-management program will help families maintain their new behaviors. CONCLUSIONS: These recommendations provide practical guidance to pediatric clinicians who evaluate and treat overweight children.

Body mass index · Childhood obesity · Family medicine · Management of obesity · Obesity · Overweight · Physical therapy · Weight loss · Weight management · Child Nutrition and Feeding Issues · Internal Medicine · Medicine · Obesity, Physical Activity, Diet · Pharmacology and Obesity Treatment · Pediatrics