Obesity• Obesity is associated with long-term health consequences and is influenced by genetic, behavioral, and environmental factors. Among these, only behavioral and environmental factors are modifiable during childhood, so these are the focus of clinical interventions.
RAISING THE SENSITIVE ISSUE OF WEIGHT• Because of this widespread cultural bias, many families with obesity are sensitive about discussing the issue.• avoid a blaming approach.• understand and acknowledge the role of genetics and epigenetics in the development of obesity.• some individuals gain weight more easily than others.• such people may have to “work extra-hard” to keep a healthy body weight.• generally use the words “unhealthy weight” or “weight problem” because these terms are perceived by parents as more motivating and less stigmatizing than the terms “obese” or “fat”
Dietary goals:• Limiting consumption of sugar-sweetened beverages, including juice• Encouraging a diet with ample servings of vegetables and fruits• Limiting eating at restaurants, particularly fast-food restaurants• Limiting portion size (which for young children often is less than a “serving size” as listed on a food label)
Activity goals• Activity goals: Encouraging moderate to vigorous physical activity for one or more hours daily.• Limiting television and other screen time – no screen time for children under two years of age; less than two hours daily after age two
Behavioral strategies• Behavioral strategies— Simply providing patients with education on obesity related health risks, nutrition, and physical activity is insufficient to induce behavior change. Instead, nutrition and physical activity should be thought of as habitual behaviors.