By helping young people and their families understand and put into practice positive lifestyle changes, clinicians can have a significant impact on childhood and adolescent obesity.
- Obesity is a chronic disorder of energy imbalance. Focus on both sides of the energy balance equation: energy in and energy out.
- Measure the child or adolescent’s body mass index (BMI) and plot it on a BMI-for-age chart. Also measure and record waist circumference.
- Use a developmentally sensitive approach. With children, focus on the parents as agents of change; with adolescents, provide the opportunity for the adolescent and parents to attend therapy sessions separately.
- Long term behavioural change is required, involving an increase in incidental physical activity, a reduction in sedentary behaviour (including TV viewing and other forms of passive electronic entertainment) and a sustainable change to a lower energy intake.
- In prepubertal children, weight maintenance or reduction in the rate of weight gain are appropriate goals of therapy; after puberty, weight loss is generally appropriate.
- High risk eating patterns include skipping breakfast, excessive consumption of soft drinks, cordials and fruit juices, large portion sizes and frequent snacking.