• A
  • |
  • A
  • Text size

Recommendations on the Assessment, Prevention, and Treatment of Childhood Obesity

In 2005, the AMA, HHS, and CDC convened an expert committee to develop recommendations on the assessment, prevention, and treatment of child and adolescent overweight and obesity. Briefly, the committee offered the following recommendations:*

Assessment

  • Annual measurement of weight, height, and body mass index (BMI) for age (new terminology)
    • Underweight — Below 5th percentile
    • Healthy Weight — 5th – 84th percentile
    • Overweight — 85th – 94th percentile
    • Obesity — 95th percentile or above
  • Child's medical history
  • Parental obesity
  • Family medical history
  • Other health problems related to obesity
  • Dietary, physical activity, and other behaviors

Prevention – Patient Level

Limit

Encourage

  • Sugar-sweetened beverages
  • TV/other screen time (no more than 2 hr/d)
  • Eating out/restaurants
  • Portion sizes
  • Energy-dense (high calorie) foods
  • Fruits and vegetables: 9 servings/day
  • Breakfast every day
  • Family meals
  • Physical activity (60 min/d of moderate to vigorous activity)
  • Calcium
  • Fiber
  • Balanced fat, protein, carbohydrate intake for age
  • Breastfeeding

Prevention – Practice and Community Level

  • Increase physical activity at schools (grade 1 through college)
  • Preserve and enhance parks, walking and bicycle paths
  • Encourage physicians and health professionals to support parents:
  • Authoritative (not restrictive) parenting style
  • As role models for healthy eating, physical activity, and reduced sedentary activities

Treatment

  • Goal: improve long-term health through permanent healthy lifestyle habits
  • Stages
    1. Prevention "Plus"
      More frequent physician monitoring
    2. Structured Weight Management
      More specific goals and support to child
    3. Comprehensive Multidisciplinary Intervention
      Increased frequency of visits with more providers
    4. Tertiary Care Intervention
      Medications, very low-calorie diets, and/or surgery for severely obese children

*For full details, please refer to the supplement in the December 2007 issue of Pediatrics (Volume 120, Number 3)