Revision Date: July 2013
Scope and Target Population
This guideline addresses the prevention, diagnosis and management of childhood obesity from birth through 17 years of age. The guideline encompasses a range of approaches including education, behavioral and lifestyle changes, medication and surgical options. For optimal outcomes, the child's family or other social supports as well as a multidisciplinary team (primary care clinician, consultants, dietitian, school nurse, etc.) should be included in the education, counseling and follow-up.
While we recognize the importance of addressing comorbidities, the treatment of comorbid conditions is outside the scope of this document.
In addition to individual treatment modalities, slowing the national obesity trend will require social changes in the form of healthier policies, system reforms and environmental changes where children live, learn and play. Although this document focuses on individual treatment, we recognize that health care clinicians and health care systems can be effective partners in formulating policy decisions and community design that nurture healthy children.
- Increase the percentage of patients ages 2 through 17 years who have an annual screening for obesity using body mass index (BMI) measured and whose BMI percentile status is determined.
- Increase the percentage of patients ages 2 through 17 years with an annual BMI screening who have received education and counseling regarding weight management strategies that include nutrition and physical activity.
- Increase the percentage of patients ages 2 through 17 years with a BMI screening percentile greater than 85 whose percentile decreased within 12 months of screening.
- Childhood obesity has risen at an alarming pace over the past decade, making obesity the most prevalent health problem in the majority of the developed countries.
- Obesity prevention messages should be targeted at all families, starting at the time of the child's birth.
- BMI should be calculated and documented in the medical record on all children ages 2-18 at least annually, ideally at a well child visit.
- Clinicians should conduct a focused review of systems and physical examination assessing for obesity-related comorbid conditions.
- Management intervention strategies are available and include nutrition, physical activity, behavior and lifestyle changes, medication and surgical considerations.
- Clinicians should use motivational interviewing techniques as a tool for encouraging behavior change.
- Pediatric patients and their families should be counseled on nutritional interventions including limiting sugar-sweetened beverages, eating nutrient-dense breakfasts, limiting eating out at fast food restaurants, families eating together, among other nutritional strategies.