The growing incidence of pediatric obesity is widely recognized as epidemic, but strategies to cope with increasing pediatric girth have been slow to appear. A crowded PAS session on Sunday morning highlighted four promising programs.

Wendelin Slusser, MD, of University of California Los Angeles, focuses on healthy lifestyle rather than identifying obesity as a clinical target.

“We focus on wellness and health because that is what our target audience responds to,” Dr. Slusser said. “I don’t think there’s a parent out there who doesn’t want their child to be well and healthy.”

The key tool is a Lifestyle Log in the patient chart. The log details diet, physical activity, time spent watching television, and family food-buying habits. The log makes it easy to target specific behaviors such as switching from full-fat milk to 1% milk, she explained.

Thomas Robinson, MD, MPH, of Stanford University School of Medicine in Palo Alto, Calif. studies school programs. Simple interventions such as lowering the price of fruits and vegetables, and increasing the price of unhealthy foods at school cafeterias, can have a dramatic impact on eating habits and nutrition, he said.

Third, Lakshmi Dhanvanthari, MD, of BlueCross of California, outlined a proprietary obesity control program for providers and patients. The key, she said, is reimbursement for obesity counseling and care.

Finally, Arkansas has an aggressive school-based program to promote child health. School vending machines have been eliminated or restricted, cafeteria workers receive nutrition education, and parents receive a health report card that includes each child’s BMI and action recommendations.

“We have not seen a single adverse event associated with those health reports,” said Arkansas Surgeon General Joseph Thompson, MD, MPH. “And parental awareness of obesity problems has more than doubled.”