Expert committee recommendations regarding the prevention, assessment, and treatment of child and adolescent overweight and obesity: Summary report
Expert committee recommendations regarding the prevention, assessment, and treatment of child and adolescent overweight and obesity: Summary report
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DOI：
10.1542/peds.2007-2329c
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发表时间：
2007-12-01
期刊：
影响因子：
8
通讯作者：
Barlow, Sarah E.
中科院分区：
文献类型：
--
作者：
Barlow, Sarah E.
为了修订1998年关于儿童肥胖的建议，一个由15个专业组织的代表组成的专家委员会任命了经验丰富的科学家和临床医生组成3个写作小组，审查文献并建议预防、评估和治疗方法。由于有效的策略仍然没有得到很好的定义，写作小组使用了现有的证据和专家意见来制定建议。初级保健提供者应普遍评估儿童的肥胖风险，以改善早期识别BMI升高，医疗风险，以及不健康的饮食和体育活动习惯。提供者可以为大多数儿童提供预防肥胖的信息，并为超重儿童建议体重控制干预措施。写作小组还建议改变办公系统，以便他们支持解决问题的努力。BMI应至少每年计算并绘制一次，并将分类与生长模式、家族肥胖和医疗风险等其他信息结合起来，以评估儿童的肥胖风险。对于预防，建议包括具体的饮食和体育活动行为，这可能会促进健康体重的维持，但也可以使用以患者为中心的咨询技术，如动机访谈，这有助于家庭确定自己做出改变的动机。对于评估，建议包括筛选当前医疗条件和未来风险的方法，以及评估饮食和体育活动行为的方法。对于治疗，建议提出了4个阶段的肥胖护理;第一个是可以在卫生保健办公室提供的简短咨询，随后的阶段需要更多的时间和资源。更高阶段的适当性受患者年龄和超重程度的影响。这些建议认识到社会和环境变化对减少肥胖流行的重要性，但也确定了医疗保健提供者和医疗保健系统可以成为更广泛努力的一部分的方式。
To revise 1998 recommendations on childhood obesity, an Expert Committee, comprised of representatives from 15 professional organizations, appointed experienced scientists and clinicians to 3 writing groups to review the literature and recommend approaches to prevention, assessment, and treatment. Because effective strategies remain poorly defined, the writing groups used both available evidence and expert opinion to develop the recommendations. Primary care providers should universally assess children for obesity risk to improve early identification of elevated BMI, medical risks, and unhealthy eating and physical activity habits. Providers can provide obesity prevention messages for most children and suggest weight control interventions for those with excess weight. The writing groups also recommend changing office systems so that they support efforts to address the problem. BMI should be calculated and plotted at least annually, and the classification should be integrated with other information such as growth pattern, familial obesity, and medical risks to assess the child's obesity risk. For prevention, the recommendations include both specific eating and physical activity behaviors, which are likely to promote maintenance of healthy weight, but also the use of patient-centered counseling techniques such as motivational interviewing, which helps families identify their own motivation for making change. For assessment, the recommendations include methods to screen for current medical conditions and for future risks, and methods to assess diet and physical activity behaviors. For treatment, the recommendations propose 4 stages of obesity care; the first is brief counseling that can be delivered in a health care office, and subsequent stages require more time and resources. The appropriateness of higher stages is influenced by a patient's age and degree of excess weight. These recommendations recognize the importance of social and environmental change to reduce the obesity epidemic but also identify ways healthcare providers and health care systems can be part of broader efforts.