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Canadian pediatric obesity guidelines recommend lifestyle changes, discourage drugs or surgery
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In its first update in 20 years to obesity guidelines specifically for children, the Canadian Task Force on Preventive Health Care advises routine monitoring of children’s growth and offering behavioral structured interventions to those with obesity.
The guidelines are based on a systematic review of current research and weighted by quality of evidence.
“Parents often underestimate their children’s weight, which is why continual growth monitoring by a health care provider is important,” Paula Brauer, PhD, a member of the child obesity guideline working group, said in a press release. “Children naturally gain weight as they grow; by regularly measuring and plotting a child’s growth, a physician or nurse can determine if the child is maintaining a healthy growth pattern or if he or she is at risk of being overweight or obese.”
The task force provides a weak recommendation against routinely offering interventions aimed at preventing overweight and obesity in children with a healthy body weight.
For children with overweight or obesity, the task force gives a weak recommendation for behavioral interventions, based on moderate quality evidence.
“Most effective behavioral interventions were comprehensive, delivered by a specialized interdisciplinary team, involved group sessions, and incorporated parent and family involvement,” the task force wrote. “Clinicians should discuss the limited evidence showing a short-term benefit with their patients and must help each family to make a decision that is consistent with their values and preferences.”
For the most part, pharmacologic and surgical interventions for children with obesity are supported only by very low-quality evidence, and the task force issues a strong recommendation against providing these treatments to children with obesity. Moderate-quality evidence supports a weak recommendation against the use of Xenical (orlistat, Roche) or Alli (orlistat, GlaxoSmithKline) in adolescents, according to the task force.
“Childhood obesity is complex; influenced by different parenting styles, family lifestyles and parents’ knowledge of what constitutes healthy growth,” Patricia Parkin, MD, FRCPC, chair of the child obesity guideline working group, said in the release. “Primary care doctors and other health care professionals play an important role in the battle against childhood obesity, which is a major health challenge in Canada. To be successful, we must involve the entire family and tailor solutions that meet their varied needs.” – by Jill Rollet
Disclosure: The researchers report no relevant financial disclosures.
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