Pediatric Obesity—Assessment, Treatment, and Prevention
Diagnosis
Diagnosing Overweight and Obesity
Genetic Obesity Syndromes
Prevention
- avoiding the consumption of calorie-dense, nutrient-poor foods (e.g., sugar-sweetened beverages, sports drinks, fruit drinks, most "fast foods" or those with added table sugar, high-fructose corn syrup, high-fat or high-sodium processed foods, and calorie-dense snacks)
- encouraging the consumption of whole fruits rather than fruit juices.
Treatment
Obesity Lifestyle: General Considerations
- decreased consumption of fast foods
- decreased consumption of added table sugar and elimination of sugar-sweetened beverages
- decreased consumption of high-fructose corn syrup and improved labeling of foods containing high-fructose corn syrup
- decreased consumption of high-fat, high-sodium, or processed foods
- consumption of whole fruit rather than fruit juices
- portion control education
- reduced saturated dietary fat intake for children and adolescents >2 years of age
- US Department of Agriculture recommended intake of dietary fiber, fruits, and vegetables
- timely, regular meals, and avoiding constant "grazing" during the day, especially after school and after supper
- recognizing eating cues in the child’s or adolescent’s environment, such as boredom, stress, loneliness, or screen time
- encouraging single portion packaging and improved food labeling for easier use by consumers.
- The patient has attained Tanner 4 or 5 pubertal development and final or near-final adult height, the patient has a BMI of >40 kg/m2 or has a BMI of >35 kg/m2 and significant, extreme comorbidities.
- Extreme obesity and comorbidities persist despite compliance with a formal program of lifestyle modification, with or without pharmacotherapy.
- Psychological evaluation confirms the stability and competence of the family unit [psychological distress due to impaired quality of live (QOL) from obesity may be present, but the patient does not have an underlying untreated psychiatric illness].
- The patient demonstrates the ability to adhere to the principles of healthy dietary and activity habits.
- There is access to an experienced surgeon in a pediatric bariatric surgery center of excellence that provides the necessary infrastructure for patient care, including a team capable of long-term follow-up of the metabolic and psychosocial needs of the patient and family.
Recommendation Grading
Overview
Title
Pediatric Obesity—Assessment, Treatment, and Prevention
Authoring Organization
Endocrine Society
Endorsing Organization
Pediatric Endocrine Society
Publication Month/Year
January 31, 2017
Last Updated Month/Year
October 8, 2024
Supplemental Implementation Tools
Document Type
Guideline
External Publication Status
Published
Country of Publication
US
Document Objectives
To formulate clinical practice guidelines for the assessment, treatment, and prevention of pediatric obesity.
Inclusion Criteria
Male, Female, Adolescent, Child
Health Care Settings
Ambulatory, Childcare center, School
Intended Users
Nurse, nurse practitioner, physician, physician assistant
Scope
Assessment and screening, Treatment, Management, Prevention
Diseases/Conditions (MeSH)
D009765 - Obesity, D063766 - Pediatric Obesity
Keywords
obesity, pediatric obesity, childhood obesity
Source Citation
Dennis M. Styne, Silva A. Arslanian, Ellen L. Connor, Ismaa Sadaf Farooqi, M. Hassan Murad, Janet H. Silverstein, Jack A. Yanovski, Pediatric Obesity—Assessment, Treatment, and Prevention: An Endocrine Society Clinical Practice Guideline, The Journal of Clinical Endocrinology & Metabolism, Volume 102, Issue 3, 1 March 2017, Pages 709–757, https://doi.org/10.1210/jc.2016-2573