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Obesity evaluation and treatment: Expert Committee recommendations. The Maternal and Child Health Bureau, Health Resources and Services Administration and the Department of Health and Human Services.

Abstract

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.

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  • Publisher Full Text
  • Authors+Show Affiliations

    ,

    Division of Pediatric Gastroenterology and Nutrition, New England Medical Center, Boston, Massachusetts, USA.

    Source

    Pediatrics 102:3 1998 Sep pg E29

    MeSH

    Adolescent
    Body Mass Index
    Child
    Endocrine System Diseases
    Exercise
    Feeding Behavior
    Feeding and Eating Disorders
    Health Promotion
    Humans
    Life Style
    Mental Disorders
    Obesity
    Parenting
    Referral and Consultation
    Risk Assessment
    Skinfold Thickness
    United States

    Pub Type(s)

    Guideline
    Journal Article
    Practice Guideline
    Research Support, U.S. Gov't, P.H.S.

    Language

    eng

    PubMed ID

    9724677

    Citation

    TY - JOUR T1 - Obesity evaluation and treatment: Expert Committee recommendations. The Maternal and Child Health Bureau, Health Resources and Services Administration and the Department of Health and Human Services. AU - Barlow,S E, AU - Dietz,W H, PY - 1998/9/2/pubmed PY - 1998/9/2/medline PY - 1998/9/2/entrez SP - E29 EP - E29 JF - Pediatrics JO - Pediatrics VL - 102 IS - 3 N2 - 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. SN - 1098-4275 UR - https://www.unboundmedicine.com/medline/citation/9724677/full_citation L2 - http://pediatrics.aappublications.org/cgi/pmidlookup?view=long&pmid=9724677 ER -