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PEDIATRICS Vol. 110 No. 1 July 2002, pp. 236-238

Management of Child and Adolescent Obesity: Summary and Recommendations Based on Reports From Pediatricians, Pediatric Nurse Practitioners, and Registered Dietitians

Sarah E. Barlow, MD, MPH* and William H. Dietz, MD, PhD{ddagger}

* St Louis University School of Medicine, St Louis, Missouri
{ddagger} Division of Nutrition and Physical Activity, Centers for Disease Control and Prevention, Atlanta, Georgia

Abbreviations: MCHB, Maternal and Child Health Bureau • HRSA, Health Resources and Services Administration • DHHS, Department of Health and Human Services • NCEMCH, National Center for Education in Maternal and Child Health • RD, registered dietitian • PNP, pediatric nurse practitioner • BMI, body mass index

The first 300 words of the full text of this article appear below.


   INTRODUCTION
 
Intensive, behavior-based weight loss programs for children have proved successful in clinical studies,1 but these approaches have not yet been translated to effective office care. In 1996, the Maternal and Child Health Bureau (MCHB), Health Resources and Services Administration (HRSA), Department of Health and Human Services (DHHS), and the National Center for Education in Maternal and Child Health (NCEMCH) convened a committee of experts in childhood obesity to recommend the medical, emotional, and behavioral evaluations that should precede efforts to control weight, and appropriate intervention approaches shown to be successful in comprehensive behavior programs.2 Although the effectiveness of the recommendations has not yet been tested, they represent the best available guide for practice.

Physicians, registered dietitians (RDs), and pediatric nurse practitioners (PNPs) care for more overweight patients now than they did several decades ago. Not all address the problem or evaluate and treat overweight children and adolescents in ways that are consistent with the expert recommendations. A review of current practices to identify those that commonly differ from recommendations will guide development of strategies to assist providers in following recommended practices. Potential interventions include education, removal of barriers in the health care system, and practical office aids such as body mass index (BMI) calculators or medical evaluation checklists. The assessment of needs to identify problem areas is the first step to improve provider practices.

Research about the attitudes and practices of pediatric health care providers when they address obesity is sparse. Price et al3 found a high level of concern about obesity among members of the American Academy of Pediatrics. However, they focused primarily on treatment recommendations and did not seek information about medical, psychological, or emotional evaluation, or barriers to care. Other studies have assessed attitudes and practices of physicians of adult patients.4–6 We undertook the present study to . . . [Full Text of this Article]

Reprint requests to (S.E.B.) Cardinal Glennon Children’s Hospital, 1465 S Grand Blvd, St Louis, MO 63104. E-mail: barlowse@slu.edu




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