Document Detail


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.
MedLine Citation:
PMID:  9724677     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
S E Barlow; W H Dietz
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Publication Detail:
Type:  Guideline; Journal Article; Practice Guideline; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Pediatrics     Volume:  102     ISSN:  1098-4275     ISO Abbreviation:  Pediatrics     Publication Date:  1998 Sep 
Date Detail:
Created Date:  1998-09-14     Completed Date:  1998-09-14     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0376422     Medline TA:  Pediatrics     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  E29     Citation Subset:  IM    
Affiliation:
Division of Pediatric Gastroenterology and Nutrition, New England Medical Center, Boston, Massachusetts, USA.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Body Mass Index
Child
Eating Disorders / complications,  diagnosis,  therapy
Endocrine System Diseases / complications
Exercise
Food Habits
Health Promotion
Humans
Life Style
Mental Disorders / complications
Obesity / diagnosis*,  etiology,  therapy*
Parenting
Referral and Consultation
Risk Assessment
Skinfold Thickness
United States

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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