Treating Obesity in Children and Adolescents with Special Healthcare Needs

Special considerations for the adolescent with obesity: An obesity medicine association (OMA) clinical practice statement (CPS) 2024

“…A multidisciplinary team is essential for coordinating care around weight management for families with SCHN. Key team members include physician or nurse practitioner with experience working with special needs patients, psychologist, dietitian, social worker, occupational therapy and physical therapy as needed [ 37 ].…”

“…Within the weight management team and support staff, care conferences and coordinated weight management visits with the whole team allow joint problem solving with parents in the moment and development of a comprehensive care plan. Families are appreciative of this approach, allowing clarification of confusing or competing recommendations [ 37 ].…”

“…Families of adolescents with SHCN often can handle a “menu of goals” more complex than a typical weight management family due to increased experience interacting with the healthcare system. Often, adolescents with SHCN experience a good response to treatment with less frequent follow-ups, which assists in balancing other medical appointments [ 37 ]. Telehealth visits are extremely helpful to allow brief participation of the adolescent who can leave the conversation as needed, allowing the parent to focus with the provider on education and recommendations [ [38] , [39] , [40] ].…”

“…When assessing the adolescent patient, factoring in adolescent behavioral and sexual development, severity of obesity, severity of hunger and satiety signals, amount of behavioral dysregulation and food focus is key to plan of care development. Additional obesity related comorbidities [ 41 ], changes in weight set point, food selectivity, and medication side effects are also important factors to consider [ 37 ].…”

“…When trying new foods, this strategy can help overcome previous reluctancies. Working on alternating foods, not repeating a food for 48 hours, and limiting portion sizes can lead to improvements in weight status without adding new foods [ 37 ].…”