Obesity is influenced by genetic, behavioral, and environmental factors. Clinical interventions should focus on modifying behavioral and environmental factors during childhood. When discussing weight with families, providers should avoid blame and acknowledge genetic influences. They should encourage a diet with vegetables and fruits, limit sugar-sweetened drinks and fast food, and aim for daily physical activity while limiting screen time. Education alone is not enough to change behaviors - nutrition and activity need to be thought of as habits.

1. How can we control obesity

2. 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.

3. 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”

4. 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)

5. 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

6. 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.