Obesity evaluation and treatment: Expert committee recommendations
Obesity evaluation and treatment: Expert committee recommendations
复制标题
DOI：
10.1542/peds.102.3.e29
复制
发表时间：
1998-09-01
期刊：
影响因子：
8
通讯作者：
Dietz, WH
中科院分区：
文献类型：
--
作者：
Barlow, SE;Dietz, WH
目标.为医生、执业护士和营养学家制定建议，以指导超重儿童和肥胖儿童的评估和治疗。妇幼保健局，卫生资源和服务管理局，卫生和公共服务部召集了一个儿童肥胖专家委员会，以制定建议，结果。委员会建议，体重指数大于或等于第85百分位数并伴有肥胖症的儿童，或体重指数大于或等于第95百分位数并伴有或不伴有肥胖症的儿童，应接受评估和可能的治疗。临床医生应该注意罕见的外源性肥胖原因的迹象，包括遗传综合征，内分泌疾病和心理障碍。他们应该筛查肥胖的并发症，包括高血压、血脂异常、骨科疾病、睡眠障碍、胆囊疾病和胰岛素抵抗。需要咨询儿科肥胖专家的情况包括假性脑瘤、肥胖相关的睡眠障碍、骨科问题、大量肥胖和2岁以下儿童肥胖。治疗评估的建议包括评估患者和家庭是否准备好参与体重管理计划，以及重点评估饮食和体育活动习惯。肥胖治疗的主要目标应该是健康饮食和活动。使用体重维持与体重减轻来实现体重目标取决于每个患者的年龄、基线BMI百分位数和医疗并发症的存在。委员会建议及早开始治疗，让家庭参与，并逐步进行永久性改变。育儿技能是成功干预的基础，这种干预可以逐步、有针对性地增加活动，并有针对性地减少高脂肪、高热量食物。在最初的体重管理计划之后，对家庭的持续支持将有助于家庭保持他们的新行为。这些建议为评估和治疗超重儿童的儿科临床医生提供了实用的指导。
Objectives. The development of recommendations for physicians, nurse practitioners, and nutritionists to guide the evaluation and treatment of overweight children and adolescents.Methods. The Maternal and Child Health Bureau, Health Resources and Services Administration, the Department of Health and Human Services convened a committee of pediatric obesity experts to develop the recommendations,Results. The Committee recommended that children with a body mass index (BMI) greater than or equal to the 85th percentile with complications of obesity or with a BMI greater than or equal to the 95th percentile, with or without complications, undergo evaluation and possible treatment. Clinicians should be aware of signs of the rare exogenous causes of obesity, including genetic syndromes, endocrinologic diseases and psychologic disorders. They should screen for complications of obesity, including hypertension, dyslipidemias, orthopedic disorders, sleep disorders, gall bladder disease, and insulin resistance. Conditions that indicate consultation with a pediatric obesity specialist include pseudotumor cerebri, obesity-related sleep disorders, orthopedic problems, massive obesity, and obesity in children younger than 2 years of age. Recommendations for treatment evaluation included an assessment of patient and family readiness to engage in a weight-management program and a focused assessment of diet and physical activity habits. The primary goal of obesity therapy should be healthy eating and activity. The use of weight maintenance versus weight loss to achieve weight goals depends on each patient's age, baseline BMI percentile, and presence of medical complications. The Committee recommended treatment that begins early, involves the family, and institutes permanent changes in a stepwise manner. Parenting skills are the foundation for successful intervention that puts in place gradual, targeted increases in activity and targeted reductions in high-fat, high-calorie foods. Ongoing support for families after the initial weight-management program will help families maintain their new behaviors.Conclusions. These recommendations provide practical guidance to pediatric clinicians who evaluate and treat overweight children.