The guidelines emphasize a comprehensive, evidence-based approach to diagnosing and treating pediatric obesity, highlighting the importance of behavioral interventions, family involvement, and multidisciplinary collaboration. Here are key takeaways for practitioners:
1. Accurate Diagnosis Using BMI Percentiles
Utilize the Korean National Growth Charts body mass index (BMI) percentiles to diagnose overweight and obesity in children and adolescents over 2 years of age. Overweight is defined as a BMI above the 85th but below the 95th percentile, while obesity is a BMI above the 95th percentile.
2. Comprehensive Treatment Approaches
Adopt a family-based, comprehensive, multidisciplinary team approach to behavioral interventions. This includes:
- Active vigorous physical activity
- Reduction of sedentary behaviors
- Calorie-controlled diet
These strategies are supported by high-quality evidence (strength of evidence, I; grade of recommendation, A).
3. Role of Pharmacotherapy and Surgery
Pharmacotherapy and bariatric surgery should be considered only for patients with morbid obesity and major comorbidities after intensive lifestyle modification programs have failed. The guidelines recommend close monitoring of the response and adverse reactions to pharmacologic treatments.
4. Behavioral Interventions
Implement dietary changes, such as reducing the intake of sugar-sweetened beverages and total energy intake, and using smaller-sized plates or bowls. Encourage regular physical activity, aiming for at least 20 minutes of moderate to vigorous exercise, 5 days per week.
5. Addressing Mental Health
Monitor obese children for psychological problems and involve family in the treatment process. Cognitive behavioral therapy (CBT) can be beneficial for treating childhood obesity by promoting healthy lifestyle changes and improving self-regulation skills.
Encouraging Further Research
Practitioners are encouraged to stay updated with the latest research and continuously incorporate evidence-based practices into their treatment plans. The guidelines serve as a foundation, but ongoing research and adaptation are crucial for optimizing outcomes.
To read the original research paper, please follow this link: Clinical practice guideline for the diagnosis and treatment of pediatric obesity: recommendations from the Committee on Pediatric Obesity of the Korean Society of Pediatric Gastroenterology Hepatology and Nutrition.
