AAP shifts focus for managing child obesity
Research and clinical approaches for managing obesity in children and adolescents typically stress intervention, but updated recommendations from the American Academy of Pediatrics (AAP) call for a greater focus on primary prevention.
“What I see as really central here is the whole question about how to think about the development of obesity. We know that it is really hard to treat once it develops. So I think we would really benefit from a philosophy that is really preventive in its focus,” says Stephen R. Daniels, MD, PhD, FAAP, chair of the department of pediatrics at the University of Colorado School of Medicine and pediatrician-in-chief at Children’s Hospital Colorado in Denver. Daniels co-authored the updated recommendations with Sandra G. Hassink, MD, FAAP, president of AAP and pediatrician at Nemours/Alfred I DuPont Hospital for Children in Wilmington, Delaware, and the rest of the AAP Committee on Nutrition.
Daniels says pediatricians should be offering education and behavior enhancement for all families, but focusing their efforts on those families with a history or progression toward obesity. “They ought to be the focus of much more intensive interactions around their diet and their physical activity,” he says.
Pediatricians know firsthand the struggles with managing childhood obesity. A trend that is growing all too quickly, this public health crisis has grown from 7% of children in 1980 to 18% in 2012.
According to the Centers for Disease Control and Prevention, childhood obesity rates have more than doubled among children and quadrupled among adolescents over the last 30 years.
In its new clinical report “The Role of the Pediatrician in Primary Prevention of Obesity,” the AAP modernizes its guidance on how to tackle the growing obesity epidemic with suggestions for introducing healthy habits into the lives of families with young children and adolescents; education about well-balanced diets; and tips for increasing physical activity and reducing sedentary behaviors. Although the update includes some changes from its previous incarnation from 2003, Daniels says the biggest philosophical change is the recognition that there has been far more research into treating obesity than preventing it.
“In looking at the literature, many principles that have been learned in the treatment of obesity can actually be applied in prevention,” he says, discussing how the new recommendations were created. “It’s changing behaviors, and focusing on specific areas related to diet or activity. While we do need more prevention research, we’re actually in a better position than we might have been because of the treatment studies.”