Prevention and management of childhood obesity in a primary care setting

BMI: body mass index; GLP-1: glucagon-like peptide 1; HBLT: health behavior and lifestyle treatment.

* A sharp rise in BMI refers to an upward deflection on the BMI curve that is substantially steeper than the nearby centile curves over 6 to 12 months.

¶ Greater intensity of counseling generally improves efficacy. The type and frequency of counseling should be selected collaboratively with the family, and the family should select a treatment path that they feel is feasible. Intensive treatment refers to length and frequency of visits and does not imply increased pressure or focus on dieting. If it is not possible to provide the necessary contact hours in the primary care setting, the primary care clinician still has an important role in overseeing longitudinal care and guiding the family to optimal care through community programs or consultants.

Δ Severe obesity is defined as BMI ≥120% of the 95^th percentile or ≥35 kg/m² (whichever is lower). This corresponds to approximately the 98^th percentile or BMI Z-score ≥2.2 (ie, 2.2 standard deviations above the mean).