HealthCheck Training
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Post-Test
Overview
Health Supervision
- Introduction
- Health History
- Physical Examination
- Screening Services
- Laboratory Tests
- Immunizations
- Health Education
Special Health Issues
- Introduction
- Dental Health
- Overweight and Obesity
- HIV Guidelines
- Child Abuse & Neglect
- Language Barriers
- Early Intervention
Documentation
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Special Health Issues
Overweight and Obesity, cont.
Treatment
The primary goal of a program to treat uncomplicated obesity is to achieve healthy eating and physical activity behaviors, rather than obtaining ideal body weight. Treatment programs need to emphasize the skills necessary to change behaviors and to maintain those changes. The first step toward weight control for all overweight children (older than 2 years) and adolescents is weight maintenance, which can be achieved by modest changes in food intake and physical activity. Children and adolescents who are excessively overweight (weighing 180 percent or more of their ideal body weight) cannot be expected to increase activity levels dramatically. Small incremental changes should be the goal. Weight loss, if warranted, should be only about 1 pound per month.1 Recommendations for achieving weight goals are shown in Figure 6. An appropriate weight goal for all obese children and adolescents is a BMI at or below the 85th percentile, although such a goal should be secondary to the primary goal of healthy eating, regular physical activity, and psychological well-being.
Approaches to Treatment
Children and adolescents receiving anticipatory guidance or treatment for obesity need to be monitored carefully by health professionals from a variety of disciplines, which can help families achieve many aspects of a weight-management program. Experience in cognitive-behavioral approaches to intervention are helpful. The following approaches are based on the recommendations of an expert committee of pediatric health professionals.1
- Intervention should begin early.
- The approach should involve family members. The goal is to help family members achieve healthy behaviors rather than to single out the overweight child or adolescent.
- Start slowly. Ask families to suggest one or two changes, then help them determine how to monitor the changes.
- Families should learn how to monitor eating and physical activity as part of the treatment process.
- Because weight maintenance is an important first step, families of children or adolescents who have maintained their weight should be praised for their success.
- Treatment programs should seek to institute permanent changes, avoiding short-term diets or physical activity programs aimed at rapid weight loss.
- Health professionals need to encourage and empathize rather than criticize.
- Health professionals need to educate families about the medical complications of obesity.
- Children and adolescents should never be placed on a restricted diet to lose weight except for medical reasons, when closely supervised by a health professional.
Referral
Children or adolescents who present with serious complications of obesity need to be closely monitored by a health professional and referred (if possible) to a pediatric obesity treatment program. Complications that indicate referral or consultation include pseudotumor cerebri, sleep apnea, obesity hypoventilation syndrome, Blount’s disease (tibia vara), slipped capital femoral epiphysis, and severe overweight (above the 99th percentile).1
This concludes the Overweight and Obesity portion of the Special Health Issues section. The next page contains information on HIV Guidelines. |
