PEDIATRICS Vol. 123 Supplement June 2009, pp. S253-S257 (doi:10.1542/peds.2008-2780B)
SUPPLEMENT ARTICLE |
Responding to the Childhood Obesity Epidemic: From the Provider Visit to Health Care Policy—Steps the Health Care Sector Can Take
National Initiative for Children's Healthcare Quality, Cambridge, Massachusetts
Abbreviations: MYOC—Maine Youth Overweight Collaborative • COAT—Children's Obesity Action Team • NICHQ—National Initiative for Children's Healthcare Quality • COAN—Childhood Obesity Action Network
| The first 300 words of the full text of this article appear below. |
Pediatricians, along with most of the American public, now well know that childhood obesity is a leading threat to the long-term health of the population, rivaling smoking in its potential impact. What pediatricians and other health professionals who deal with children have not known is what they can do to affect this epidemic and how they can be most effective in doing it.
From the perspective of the clinician in practice, the problem of obesity seems overwhelming. The number of children affected is vast, with healthy lifestyles a concern for all children and overweight or obesity affecting as many as one quarter of children ages 2–19 years. In part because of the limited emphasis on effective counseling methods in traditional medical education, addressing behaviors such as increasing use of car seats or reducing tobacco use is difficult for many clinicians. This has been the case even when the evidence is strong and there is broad societal support for these changes. Behaviors related to diet and physical activity seem even more difficult to influence, not only because they are embedded in family and ethnic culture, but because so many societal and community pressures lean on the side of foods of lower nutritional value (eg, sugar-sweetened beverages, highly processed fast foods) and limited exercise (unsafe neighborhoods, absence of sidewalks). Health professionals may feel that influencing these societal behaviors and policies are outside the scope of their professional role.
Health professionals have also been unsure what to do, because no unequivocal direct scientific evidence links clinician counseling to the prevention of obesity. This has been clearly stated by the US Preventive Services Task Force (USPSTF), which reported in 2005 that there was insufficient evidence to recommend for or against counseling about childhood obesity by clinicians.1
However, although most observers acknowledge the state of
Address correspondence to Charles J. Homer, MD, MPH, National Initiative for Children's Healthcare Quality, 20 University Rd, 7th Floor, Cambridge, MA 02138. E-mail: chomer@nichq.org
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