Peds Obesity

Question 1

Adolescent Weight loss Surgery Eligibility

Answer 1

Tanner stage IV or V
95% bone growth
Good understanding of lifestyle changes
Strong social support
Stable psychological disease

Question 2

Nutrition Recommendations (Consistent Evidence)

Answer 2

Eat at the table as a family at least 5-6 times weekly
Limit screen time to 2 hours a day or less
Involve the whole family in lifestyle changes
Allow the child to self-regulate his or her meals and avoid overly restrictive feeding behaviors in children less than 12

Question 3

Weight loss Targets

Answer 3

Age 2-5 years - weight maintenance until BMI <85th - if loss should not exceed 1 lb/month
Age 6-11 years - weight maintenance for BMI <99% with loss of 1 lb/month; >99%tile should have no more than 2 lb/week
Age >12 years - weight loss no more than 2 lb/week

Question 4

Comprehensive Multidisciplinary Intervention (Stage 3) - Consistent evidence

Answer 4

Structured behavioral modification program including food and activity monitoring with short term diet and PA goals, parents/caregivers involved in behavioral modification of children <12, Weekly visits for 8-12 weeks with monitoring; Follow-up weekly

Question 5

Four Tiered approach to managing obesity

Answer 5

Stage 1 - Prevention Plus (all mixed evidence recommendations except screen time) Follow-up Monthly
Stage 2 - Structured Weight Management (only consistent evidence in increased monitoring of food intake, physical activity, screen time, eating out by provider and family) Follow-up every 2 weeks
Stage 3 - Comprehensive Multidisciplinary Intervention
Stage 4 - Tertiary Care Intervention

Question 6

Prevention Counseling

Answer 6

5-4-3-2-1-0:
5 servings of fruits/veggies, 4 servings of water, 3 servings of low fat dairy, 2 hours or less of screen time, 1 hour or more of physical activity, 0 sugary drinks every day!

Question 7

Prevention of Obesity (Consistent Evidence)

Answer 7

Limit sweetened beverage use
Limit eating out
Increase family meals together at home
Limit portion size
Eat Breakfast daily
Limit daily hours of screen time

Question 8

Nutrition Recommendations (Mixed Evidence)

Answer 8

5 or more servings of fruits/veggies per day
Minimize or ideally eliminate sugary/sweet beverages
Prepare meals at home
Consume a healthy breakfast every day

Question 9

Comprehensive Multidisciplinary Intervention (Stage 3) - Consistent evidence

Answer 9

Structured behavioral modification program including food and activity monitoring with short term diet and PA goals, parents/caregivers involved in behavioral modification of children <12, Weekly visits for 8-12 weeks with monitoring; Follow-up weekly