Objective: To compare and contrast 5 sets of expert recommendations about the treatment of childhood and adolescent obesity.
Method: We reviewed 5 sets of recent expert recommendations: 2007 health care organizations' four stage model, 2007 Canadian clinical practice guidelines, 2008 Endocrine Society recommendations, 2009 seven step model, and 2010 U.S. Preventive Task Force recommendations. We described an empirically based sequential model by which expert recommendations may affect weight loss outcomes and then examined the recommendations pertaining to 4 treatments (self-help groups, outpatient cognitive behavior therapy [CBT], immersion CBT, and surgery).
Results: All of the expert committees supported using intensive dietary, physical activity, and cognitive-behavioral counseling; 2 of the 5 groups discouraged reliance on educational interventions alone; and 2 of the groups advised referring clients to increasingly intensive interventions, a stepped-care approach.
Conclusions: Expert recommendations that include clear, simple, goal-oriented directions may impact the behaviors of health care providers most effectively and, in turn, help decrease childhood and adolescent obesity. Greatest benefits may accrue by encouraging health care providers and parents to view medical management and education as foundations to change but to pursue increasingly intensive viable options until overweight and obese children make clinically significant progress toward improved health and happiness.