AMA Recommends 4-Step Treatment Plan for Obese Children
The American Medical Association has given its approval to a four-stage approach for physicians to use when treating overweight or obesity in
young patients.
According to a July 17, 2008, article on the Medscape Today website, a report by the AMA's Expert Committee on the Assessment,
Prevention, and Treatment of Child and Adolescent Overweight and Obesity advises pediatricians to employ the following protocols when treating
overweight patients between the ages of 2 and 19:
- Stage I (Prevention-Plus Protocol) - Make specific dietary and physical activity recommendations, with monthly follow-up. If
body mass index does not improve in three to six months, the committee advises physicians to consider Stage II.
- Stage II (Structured Weight Management Protocol) - This more structured plan includes a structured, healthy diet; supervised
physical activity and limited computer/television; and self-monitoring via diaries or logs. The AMA advises that family clinicians may require assistance
from allied care professionals to implement this step. If BMI does not improve in 3 to 6 months, stage III is appropriate.
- Stages III (Comprehensive, Multidisciplinary Intervention) and IV (Tertiary-Care Intervention) are more intensive interventions
administered by highly trained teams expert in obesity management, intensive counseling, and behavior modification. Referral is especially indicated
for severely obese children and for those with serious obesity-related health conditions.
According to Dr. Laurie Barclay, who wrote the
Medscape article, the AMA convened the expert panel due to a "scarcity of practical strategies available to primary care clinicians to
combat the problem of childhood obesity." In addition to advocating on behalf of the four-phase treatment approach for pediatricians, the AMA
committee also encouraged parents to implement the following anti-obesity efforts on behalf of their children:
- Encourage all children to participate in at least 60 minutes of moderate to vigorous physical activity as many days as possible, and limit
television/computer time to no more than two hours per day.
- Advise children not to drink more than 1 serving per day of sweetened beverages, and limit their fast-food consumption to a maximum of once per
week.
- Families should eat meals together as often as possible.
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