Published online May 1, 2008
PEDIATRICS Vol. 121 No. 5 May 2008, pp. 1077-1078 (doi:10.1542/peds.2008-0003)
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LETTER TO THE EDITOR

Insufficient Evidence for Committee Recommendations on Obesity

George T. Laven, MD
Jess Diamond Child Assesment CenterKern Medical CenterBakersfield, CA 93305

To the Editor.—

The expert committee recommendations on obesity assessment, treatment, and prevention published in the December 2007 supplement of Pediatrics1–4 appear at first glance to carry the weight of an authoritative review. They have been published prominently in this prestigious journal, have been put forth by a committee of experts, and have been endorsed by the American Academy of Pediatrics (AAP) and other professional organizations.

However, the authors admitted that a thorough evidence-based review was not performed, that they have ventured suggestions when evidence was absent, and the programs recommended for prevention and treatment are untested.1–4 The committee has not provided information about the quality of the evidence, the potential harms, costs, effect size, or strength of support for each of the recommendations.

It is my opinion that the committee recommendations should not be promoted until we know that they are effective and that the amount of benefit is worth the effort. Given the effort required, it is imperative that a measurable benefit be demonstrated before pediatricians are expected to adopt the recommended practices.

Rather than make numerous unsupported recommendations, it would have been preferable for the authors to recommend a few of the practices that are adequately supported by evidence. It would be helpful still if the authors could offer some estimates of the quality of evidence and strength of each of their recommendations, as recommended by the AAP Steering Committee on Quality Improvement and Management.5

It would also be informative if the editors could tell us which body of the AAP endorsed the recommendations and what that endorsement signifies.

REFERENCES

  1. Barlow SE, Expert Committee. Expert committee recommendations regarding the prevention, assessment, and treatment of child and adolescent overweight and obesity: summary report. Pediatrics. 2007;120 (suppl 4):S164 –S192[Abstract/Free Full Text]
  2. Krebs NF, Himes JH, Jacobson D, Nicklas TA, Guilday P, Styne D. Assessment of child and adolescent overweight and obesity. Pediatrics. 2007;120 (suppl 4):S193 –S228[Abstract/Free Full Text]
  3. Davis MM, Gance-Cleveland B, Hassink S, Johnson R, Paradis G, Resnicow K. Recommendations for prevention of childhood obesity. Pediatrics. 2007;120 (suppl 4):S229 –S253[Abstract/Free Full Text]
  4. Spear BA, Barlow SE, Ervin C, et al. Recommendations for treatment of child and adolescent overweight and obesity. Pediatrics. 2007;120 (suppl 4):S254 –S288[Abstract/Free Full Text]
  5. American Academy of Pediatrics, Steering Committee on Quality Improvement and Management. Classifying recommendations for clinical practice guidelines. Pediatrics. 2004;114 (3):874 –877[Abstract/Free Full Text]
PEDIATRICS (ISSN 1098-4275). ©2008 by the American Academy of Pediatrics

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This Article
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