How can primary care providers manage pediatric obesity in the real world?

Authors


Correspondence
Claire DeCristofaro, MD, MS(N) Program, School of Nursing, College of Health and Human Sciences, Western Carolina University, Cullowhee, NC 28715.
Tel: 828-545-9406; Fax: 828-670-8816; E-mail: decristofaro@email.wcu.edu

Abstract

Purpose: To provide information regarding evidence-based interventions and clinical practice guidelines as a basis for a clinical toolkit utilizing a step management approach for the primary care provider in managing childhood obesity.

Data sources: Evidence-based literature including original clinical trials, literature reviews, and clinical practice guidelines.

Conclusions: Interventions can be stratified based on initial screening of children and adolescents so that selection of treatment options is optimized. For all treatments, lifestyle modifications include attention to diet and activity level. Levels of initial success, as well as maintenance of target body mass index, may be related to the intensity and duration of interventions; involvement of family may increase success rates. For failed lifestyle interventions, or for patients with extreme obesity and/or certain comorbidities, pharmacologic or surgical options should be considered.

Implications for practice: Many intensive programs have shown success, but the resources required for these approaches may be unavailable to the typical community provider and family. However, using current guidelines, the primary care provider can initiate and manage ongoing interventions in pediatric obesity. A toolkit for primary care implementation and maintenance interventions is provided.

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