Current Approaches to the Management of Pediatric Overweight and Obesity

Abstract

Opinion Statement Family-based behavioral intervention has been demonstrated to be an effective and safe treatment for childhood obesity and should be considered a first-line treatment option. However, access to such intensive evidence-based treatment is limited and, currently, obesity care is dominated by high intensity behavioral treatment implemented in specialty clinics or less effective, low intensity treatments implemented in primary care. However, capitalizing on the established and ongoing relationship between primary care providers and families, primary care providers hold an invaluable role in early identification of overweight and obesity, and subsequent referral to an evidence-based treatment. key aspects of effective treatment include: early intervention, moderate- to high-intensity intervention of sufficient duration, multi-component intervention targeting dietary modification, physical activity and behavioral strategies, family involvement and goals targeting family members, and follow-up contact during maintenance. The purpose of this review is to present the current empirically supported treatment options for pediatric obesity including primary care-based interventions and diagnostic tools, multi-component behavioral intervention with a focus on family-based behavioral intervention, immersion treatment, and pharmacologic and surgical management.

Systematic review of paediatric weight management interventions delivered in the home setting

“…It is now mainstream for these interventions to be caregiver‐focused, with parents viewed as the primary or sole agents of change . Despite having established efficacy, access to family‐based paediatric obesity interventions can be limited as these programmes are usually only available at academic medical centres or universities and have limited insurance reimbursement .…”

National Institutes of Health Update: Translating Basic Behavioral Science into New Pediatric Obesity Interventions

“…NIH support for studies that elucidate the psychological, social, cognitive underpinnings of obesity-related behaviors in children and their families, along with support for the design and testing of interventions based on these findings, has resulted in the development of several evidence-based, efficacious treatments for pediatric obesity (Coppock et al, 2014; Wilfley et al, 2007a). A particularly fruitful program of research by Epstein et al and colleagues incorporates both children and their parents in a family-based treatment (FBT) that has been shown to be highly efficacious (.e.g., Epstein et al, 1990; Epstein et al, 2007).…”

Recent Updates on the Efficacy of Group-Based Treatments for Pediatric Obesity

“…While existing reviews document the evidence base of childhood obesity interventions across different settings and modalities (13), little attention has specifically been given to intervention formats. Intervening with an individual family allows for tailoring of diet/physical activity recommendations and behavior modification strategies for each individual’s needs, preferences and capabilities, which is important considering the many causes and maintain factors contributing to increased weight (14).…”