Pediatric Obesity Treatment: Considerations for Diabetes Educators and Clinicians.

Prevalence rates of pediatric obesity and diabetes are rising, and pediatric health care professionals are ideally situated to address these chronic diseases using a patient- and family-centered approach. This article reviews key elements of evaluation that can inform treatment and emphasizes a comprehensive, team-based strategy. Treatment begins with motivational interviewing and building a foundation of intensive health behavior and lifestyle treatment, followed by pharmacotherapy and metabolic and bariatric surgery, when indicated.

Addressing weight bias among pediatric healthcare clinical staff.

Background: Children with obesity may experience weight-based discrimination as a result of weight bias and stigma, which can have deleterious effects on their health and wellbeing, including increased risk of dysregulated, maladaptive, and disordered eating such as restriction, purging, and binging. Prior work has shown that weight bias occurs from healthcare workers caring for adults, but less is known about the prevalence of weight bias in the pediatric healthcare setting.

Methods: We aimed to determine what proportion of pediatric healthcare professionals had attitudes of weight bias at our own institution by constructing a survey with questions from validated weight bias survey tools.

Physical Examination and Evaluation for Comorbidities in Youth with Obesity.

Obesity is a complex and chronic disease that can affect the entire body. The review of systems and physical examination are important components of the evaluation. Laboratory assessment is directed toward known cardiometabolic comorbidities.

Neighborhood park access and park characteristics are associated with weight status in youth.

This study investigated park access and park quality in the context of childhood obesity. Participants were 20,638 children ages 6-17y from a large primary care health system. Analyses tested associations of park access and park characteristics with children's weight status, and sociodemographic interactions.

Translating Family-Based Behavioral Treatment for Childhood Obesity into a User-Friendly Digital Package for Delivery to Low-Income Families through Primary Care Partnerships: The MO-CORD Study.

Significant gaps exist in access to evidence-based pediatric weight management interventions, especially for low-income families. As a part of the Centers for Disease Control and Prevention's Childhood Obesity Research Demonstration project 3.0 (CORD), the Missouri CORD (MO-CORD) team aims to increase access to and dissemination of an efficacious pediatric obesity treatment, family-based behavioral treatment (FBT), among low-income families.

Implementation of a Scalable Family-Based Behavioral Treatment for Childhood Obesity Delivered through Primary Care Clinics: Description of the Missouri Childhood Obesity Research Demonstration Study Protocol.

Significant gaps exist in access to evidence-based pediatric weight management interventions, especially for low-income families who are disproportionately affected by obesity. As a part of the Centers for Disease Control and Prevention's Childhood Obesity Research Demonstration project (CORD 3.0), the Missouri team (MO-CORD) aims to increase access to and dissemination of an efficacious pediatric obesity treatment, specifically family-based behavioral treatment (FBT), for low-income families.

Health-Related Quality of Life across Recent Pediatric Obesity Classification Recommendations.

Extreme body mass index (BMI) values (i.e., above the 97th and below the 3rd percentiles) are inaccurately represented on the Centers for Disease Control and Prevention's growth curves, which may limit the utility of BMI percentile and BMI z-score for capturing changes in clinical outcomes for patients at extreme weights.

Investigating associations between physical activity-related neighborhood built environment features and child weight status to inform local practice.

Despite evidence of the importance of neighborhood built environment features in relation to physical activity and obesity, research has been limited in informing localized practice due to small sample sizes and limited geographic coverage. This demonstration study integrated data from a local pediatric health system with nationally available neighborhood built environment data to inform local decision making around neighborhood environments and childhood obesity. Height/weight from clinic visits and home neighborhood measures from the U.

Application of the Medical Neighborhood to Children with Severe Obesity.

Background: Growth in the prevalence of severe pediatric obesity and tertiary care pediatric weight management programs supports the application of chronic disease management models to the care of children with severe obesity. One such model, the medical neighborhood, aims to optimize care coordination between primary and tertiary care by applying principles of the Patient-Centered Medical Home to all providers.

Methods: An exploration of the literature was performed describing effective programs, approaches, and coordinated care models applied to pediatric weight management and other chronic conditions.

Community Healthcare and Technology to Enhance Communication in Pediatric Obesity Care.

Childhood obesity continues to be a critical healthcare issue and a paradigm of a pervasive chronic disease affecting even our youngest children. When considered within the context of the socioecological model, the factors that influence weight status, including the social determinants of health, limit the impact of multidisciplinary care that occurs solely within the medical setting. Coordinated care that incorporates communication between the healthcare and community sectors is necessary to more effectively prevent and treat obesity.

Expectations for Treatment in Pediatric Weight Management and Relationship to Attrition.

Background: Attrition in pediatric weight management negatively impacts treatment outcomes. A potentially modifiable contributor to attrition is unmet family expectations. This study aimed to evaluate the association between adolescent and parent/guardian treatment expectations and attrition.

Patient Attendance and Outcomes in a Structured Weight Management Program.

Objectives: To determine service utilization and identify patient characteristics associated with service utilization in youth with obesity presenting for structured weight management, and to explore weight-related outcomes associated with service utilization.

Study Design: In this retrospective study conducted between January 2008 and December 2013, we examined variables associated with the care of 2089 patients aged 2-18 years presenting for an initial visit to 2 tertiary care-based, multidisciplinary structured weight management clinics.

Results: Only 53% of patients returned for a second visit, 29% returned for a third visit, and virtually none (0.

Comparison of a condensed 12-week version and a 24-week version of a family-based pediatric weight management program.

Background: The current study compares the effectiveness of a condensed 12-week version and a 24-week version of the same pediatric behavioral weight management program.

Methods: Children (n=162) between the ages of 8 and 18 years (baseline BMIz=2.39; standard deviation=0.

Childhood obesity: survey of physician assessment and treatment practices.

Background: This study examined physician experience with the 2007 Expert Committee Recommendations (ECR) on the Assessment, Prevention and Treatment of Child and Adolescent Overweight and Obesity.

Methods: Pediatricians and family physicians (n = 194) practicing in the Midwest completed a survey designed to assess knowledge of, adherence to, and self-efficacy in implementing the 2007 Expert Committee recommendations.

Results: The majority of physicians (71%) were aware of the ECR and adhered to approximately 60% of the recommendations.

Resource utilization and expenditures for overweight and obese children.

Objectives: To compare health care utilization and expenditures for healthy-weight patients, overweight patients, and patients with diagnosed and undiagnosed obesity and to examine factors associated with a diagnosis of obesity.

Design: Retrospective study using claims data from a large pediatric integrated delivery system.

Setting: An urban academic children's hospital.