Prevention and Treatment of Overweight in Children and Adolescents

Resident: Roberts
Date: Mar 26, 2010
Article title: Prevention and Treatment of Overweight in Children and Adolescents
Journal: American Family Physician
Volume: 69, number 11 pages: 2591-2598
Year : 2004
Discussion:
Recent studies suggest that 15 percent of children/adolescents in America are at risk for being overweight and 15 percent of them are. The status for being “at risk for being overweight” is correlated with the BMI, this is given to patients when their BMI is between the 85th and 95th percentile. A child that is overweight must have a BMI that is above the 95 percentile. A number of studies have shown that adolescent obesity can lead to an increased mortaility, morbidity and have an effect on social and economic welfare in adulthood. The effectiveness on weight loss interventionin adolescents is not well studied or understood. However, most intervention programs attempt to apply a combination of four treatment strategies which are: 1) Caloric restriction, 2) lifestyle exercise, 3) Decrease in sedentary behavior, 4) pharmateuticals (only in severe cases). Physicians should monitor BMI for all adolescent patients and deliver treatment strategies when individual problems have been identified. There are 3 ways to manage these case scenarios.
· BMI is less than 85 percentile: pt is not overweight and physician should reinforce healthy behaviors and monitor BMI periodically
· BMI is between 85 – 94 percentile: pt is at risk for obesity and physician should initiate weight maintenance strategies until pt can outgrow “at risk status.” Weight loss program may be initiated if necessary as well.
· BMI is above 94 percentile: pt is overweight and weight loss program should be initiated
Patients who are at risk/ or overweight shouldhave support from educated family, friends, doctors and nutritionist when possible and follow up appts should be conducted until goals are met.

Assessment: As pediatric dentists, our role should be identifying unhealthy eating habits and encouraging patients to change centain behaviors thus aiding in this process.