SUCCESSFUL WEIGHT MANAGEMENT IN CHILDREN: CAN IT BE ACHIEVED? Dr. William H. Dietz, Atlanta GA, United States of America    - Biography English - 2007-10-07

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The high prevalence of overweight children and adolescents will not likely respond to interventions directed at a single target in a single setting. Instead, like tobacco control, comprehensive programs that employ multiple strategies in a variety of settings are more likely to be effective. To address overweight effectively in medical settings, both the type of care as well as the delivery of care may need to be reconsidered. Few models distinguish between overweight and severely overweight patients. Although the initial therapeutic intervention may be comparable, a stratified approach that moves from behavioral to more aggressive interventions is warranted for the severely overweight pediatric patient. Implementation of alternative models of care delivery in accordance with the chronic care model may offer more productive approaches. For example, although physicians are well-suited to oversee care, they may not be well trained in strategies to change behavior. Group approaches that include families may be more cost-effective on than traditional medical models that address overweight individually. Finally, medical interventions limited will not be successful without environmental changes that improve nutrition and physical activity. In the US, insurance companies and managed care organizations have begun to support school and community interventions that complement the efforts that providers are trying to achieve in their offices. The conclusions in this report have not been formally disseminated by the Centers for Disease Control and Prevention and should not be construed to represent any agency determination or policy.