Obesity in childhood and adolescence and what we can do with an obese child in a pediatric health care.

Childhood obesity is one of the most serious public health challenges of the 21st century. The problem is global and it is steadily affecting health care of many countries. Increase in obesity prevalence has been slowing down in numerous countries recently. WHO Europe has organized surveillance of childhood obesity (Childhood Obesity Surveillance Initiative, COSI) since 2008. Prevalence of overweight and obesity of children from ages 6 to 9 is followed during this study. The seven-year-old children are examined in the Czech Republic, where overweight and obesity prevalence of whom is stable. In 2016 overweight was found in 7,6 % of boys and in 6,5 % of girls, obesity in 8,8 % of boys and 6,5 % of girls. However, the study "Children's Health 2016" shows that after the period of global increase of obesity until 2011, there is a period of a certain stabilization, in which there are no major changes of weight. The incidence of overweight and obesity in preschool children remains favorable in the long period. The most problematic is the incidence of obesity of school children, especially boys. To improve the care of obese children in the Czech Republic, general practitioners for children and adolescents (PLDD) were involved in the health care, the educational program for PLDD was created and implemented in 2015-2017, and in 2020 the Ministry of Health approved examination, which will enable PLDD not only to look for overweight and obese children, but also to treat them effectively. The general recommendations are supplemented by practical knowledge and recommendations of doctors treating obese children.