The Role of the Pediatrician in Primary Prevention of Obesity

Daniels, Stephen R.; Hassink, Sandra G.; Abrams, Steven A.; Corkins, Mark R.; Ferranti, Sarah D. de; Golden, Neville H.; Magge, Sheela N.; Schwarzenberg, Sarah Jane

doi:10.1542/peds.2015-1558

Cited by 321 publications

(261 citation statements)

References 109 publications

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“…78,79 Other evidence-based approaches encourage parents to include more family meals, home-prepared meals, and meals with less distractions as well as fewer discussions about weight and about dieting. 6,80 Understanding that poor body image can lead to an ED, parents should avoid comments about body weight and discourage dieting efforts that may inadvertently result in EDs and body dissatisfaction.…”

Section: An Integrated Approach To Obesity and Ed Prevention Focusesmentioning

confidence: 99%

Preventing Obesity and Eating Disorders in Adolescents

Golden¹,

Schneider²,

Wood³

et al. 2016

Pediatrics

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237

119

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Obesity and eating disorders (EDs) are both prevalent in adolescents. There are concerns that obesity prevention efforts may lead to the development of an ED. Most adolescents who develop an ED did not have obesity previously, but some teenagers, in an attempt to lose weight, may develop an ED. This clinical report addresses the interaction between obesity prevention and EDs in teenagers, provides the pediatrician with evidence-informed tools to identify behaviors that predispose to both obesity and EDs, and provides guidance about obesity and ED prevention messages. The focus should be on a healthy lifestyle rather than on weight. Evidence suggests that obesity prevention and treatment, if conducted correctly, do not predispose to EDs.

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Section: An Integrated Approach To Obesity and Ed Prevention Focusesmentioning

confidence: 99%

Preventing Obesity and Eating Disorders in Adolescents

Golden¹,

Schneider²,

Wood³

et al. 2016

Pediatrics

Self Cite

237

119

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“…1,23,25 The Fitwits office tool was implemented before the after-intervention survey, which requested the selection of 2 behavioral change goals from among 25 suggestions. The survey concluded with child and parent comment areas, prefaced by "Comments on visit with the doctor," followed by "Physician comments on visit.…”

Section: Survey and Study Development And Physician Trainingmentioning

confidence: 99%

Fitwits ^TM Leads to Improved Parental Recognition of Childhood Obesity and Plans to Encourage Change

Edwards

Powell

McGaffey³

et al. 2017

J Am Board Fam Med

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Introduction: Brief tools are needed to help physicians and parents reach consensus on body mass index (BMI) categories for children and to discuss health-improving behaviors. This study tested the Fitwits TM intervention with interactive flashcards and before and-after surveys to improve parents' perceptions of children's BMI status.Methods: We enrolled 140 parents and their 9-to 12-year-old children presenting for well child care, regardless of BMI status, scheduled with 53 Fitwits-trained physicians. The Fitwits tool guided a conversation with all parent-child dyads regarding understanding BMI, nutrition, activity, and portion sizes. A survey addressed BMI category perceptions before and after the intervention, requested 2 goal selections, and included open-ended comment areas.Results: Fifty-three percent of children were overweight or obese. The primary outcome variable was the rate of correct parental identification of their child's weight status (underweight, healthy, overweight, or obese). The survey before the intervention resulted in 50.0% correct BMI category designations. This changed to 60.6% correct perceptions after the intervention, with movement between correct overweight (34.5% to 51.7%) and obese (4.4% to 24.4%) categories. Secondary outcome variables included specific behavior change goals and the qualitative responses of parents, children, and physicians to the intervention. Parent-child dyads predominantly commented favorably and chose (75.8%) goals corresponding to Fitwits card suggestions.Conclusions: An improvement was observed in parental ability to identify the correct BMI category after the intervention during a preadolescent well child visit. Parent underrecognition of overweight/ obese children was also observed. Most parent comments were appreciative of the physician interaction,

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“…Other national medical organizations have provided recommendations or statements to providers including the American Academy of Pediatrics (AAP), the American College of Obstetrics & Gynecology (ACOG) and the American Academy of Family Physicians (AAFP) [11][12][13][14][15][16][17]. Each AAP publication promotes the use of sex-specific BMI percentile for age to screen for overweight and obesity after age 2 [11,15].…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…Each AAP publication promotes the use of sex-specific BMI percentile for age to screen for overweight and obesity after age 2 [11,15]. Physicians have been encouraged to monitor for excess weight gain relative to linear growth, to assess diet and activity levels, and to encourage healthy behaviors in all patients [11,15]. Based on the ACOG and AAFP recommendations, physicians have been advised to identify patients with overweight and obesity using height, weight, and BMI, and to counsel them about dietary modification and physical activity.…”

Section: Introductionmentioning

confidence: 99%

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Trends in Management of Overweight and Obesity in Obstetrics & Gynecology, Family Medicine and Pediatrics 2011-2015

Lindheim¹,

Welsh²,

Jiang³

et al. 2017

J Obes Eat Disord

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Purpose: To assess for improvement in the screening and management of overweight and obesity in the past 5 years among Obstetrician-Gynecologists (OB-GYN), Family Physicians (FP), and Pediatricians (Peds). Methods:A retrospective pilot study was conducted, reviewing 150 charts of patients with overweight (body mass index [BMI] 25-29.9 kg/m 2 ) and class I (BMI 30-34.9 kg/m 2 ), class II (BMI 35-39.9 kg/m 2 ), and class III obesity (BMI ≥ 40 kg/m 2 ) between 2011 and 2015. Patients were from OB-GYN (n=50), Family Medicine, adult (FP-A) (n=50) and pediatric (FP-P) (n=28), and Peds (n=22) offices.Results: 75% of patients were female; 35.5% had overweight, 40% had class I obesity, 13.3% had class II obesity, and 11.3% had class III obesity. 100% of clinicians used BMI; none used waist circumference. Peds (91%) and FP-P (96%) visits were more likely to include counseling compared to OB-GYN (30%) and FP-A (30%) visits (p<0.001). A decrease in nutrition counseling (71% vs. 29%, p<0.05) occurred between 2011 and 2015.Conclusions: There remains significant room for improvement among all providers. Peds and FP-Ps may be more sensitive to the need for managing obesity than OBGYNs and FP-As. More efforts are needed to combat the obesity epidemic, starting with accurately identifying and counseling patients with obesity. Keywords: Obesity; Mass screening; Trends IntroductionObesity is the most common chronic disease in the United States and affects more than 600 million adults worldwide [1]. Over two-thirds of American adults are overweight (body mass index [BMI] ≥ 25 kg/m 2 ), along with about 15% of children aged 2-19 (sex-specific BMI-for-age between the 85th and 94.9th percentile) (2,3). Further, one-third of adults and 17% of children are obese (BMI ≥30 kg/m 2 in adults, and sex-specific BMI-for-age ≥95th percentile in children) (2,3).The health burden of pediatric obesity is concerning, particularly since children with obesity are less likely to have healthy BMIs as adults [4]. While adult obesity still exceeds childhood obesity in the US, the percent increase in childhood obesity has been greater than that among adults in the past few decades: the relative annual increase between 1971 and 2002 has been reported at 4% in children aged 10-17 years and 1.4% in adults [5].The health risks of overweight and obesity in adults are well established, including type II diabetes, hypertension, coronary artery disease, stroke, and some cancers [6]. Obesity in children carries similar risks, including type II diabetes, hypertension, and dyslipidemia [7]. Health risks specific to females with overweight and obesity include polycystic ovarian syndrome, anovulation, infertility, and endometrial cancer [6]. Obesity during pregnancy imparts risks to both mother and child, such as gestational diabetes, cesarean section and congenital anomalies [6]. Moreover, children of mothers with obesity have an increased risk of obesity in adult life and increased all-cause mortality [6].Given the burden of disease incurred by overweight an...

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The Role of the Pediatrician in Primary Prevention of Obesity

Cited by 321 publications

References 109 publications

Preventing Obesity and Eating Disorders in Adolescents

Preventing Obesity and Eating Disorders in Adolescents

Fitwits ^TM Leads to Improved Parental Recognition of Childhood Obesity and Plans to Encourage Change

Trends in Management of Overweight and Obesity in Obstetrics & Gynecology, Family Medicine and Pediatrics 2011-2015

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The Role of the Pediatrician in Primary Prevention of Obesity

Cited by 321 publications

References 109 publications

Preventing Obesity and Eating Disorders in Adolescents

Preventing Obesity and Eating Disorders in Adolescents

Fitwits TM Leads to Improved Parental Recognition of Childhood Obesity and Plans to Encourage Change

Trends in Management of Overweight and Obesity in Obstetrics & Gynecology, Family Medicine and Pediatrics 2011-2015

Contact Info

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Resources

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Fitwits ^TM Leads to Improved Parental Recognition of Childhood Obesity and Plans to Encourage Change