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Feature Article

Managing obesity in childhood and adolescence

Louise A Baur, Susie Burrell

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Abstract

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.

Key Points

  • 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.

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