The delivery of preventive health care services in the wellness visits of children and adolescents fails to adequately identify the child and adolescent overweight and at risk for obesity and its subsequent comorbidities. There are multiple competing issues and barriers addressed in this article. However, a brief inventory of exercise and dietary and nutritional guidance is presented for the primary care clinician. Included are the appropriate history, physical exam, and laboratory evaluation that should encompass any child or adolescent at risk for obesity.
Podl TR, Goodwin MA, Kikano GE, Stange KCDirect observation of exercise counseling in community family practice. Am J Prev Med.1999;17:207-210.
2.
Flocke SA, Stange KC, Goodwin MAPatient and visit characteristics associated with opportunistic preventive services delivery. J Fam Pract.1998;47:202-208.
3.
Stange KC, Woolf SH, Gjeltema K.One minute for prevention: the power of lever-aging to fulfill the promise of health behavior counseling. Am J Prev Med.2002;22:320-323.
4.
Meriwether RA , Lobelo F., Pate RRClinical interventions to promote physical activity in youth. Am J Lifestyle Med.2008 ;2:7-25.
5.
Goodwin MA, Flocke SA, Borawski EA, Zyzanski SJ, Stange KCDirect observation of health-habit counseling of adolescents. Arch Pediatr Adolesc Med.1999;153:367-373.
6.
Barlow SE, Dietz WHObesity evaluation and treatment: expert committee recommendations. The Maternal and Child Health Bureau, Health Resources and Services Administration and the Department of Health and Human Services. Pediatrics. 1998;102:E29.
7.
Institute of Medicine.Preventing Childhood Obesity: Health in the Balance. Washington, DC: Institute of Medicine; 2004. Available at: www.iom.edu/report.asp?id=22596. Accessed October 4, 2007.
8.
Miller LA, Grunwald GK, Johnson SL, Krebs NFDisease severity at time of referral for pediatric failure to thrive and obesity: time for a paradigm shift?J Pediatr.2002 ;141:121.
9.
Dietz WH, Robinson TNClinical practice: overweight children and adolescents. N Engl J Med.2005;352:2100.
10.
Hoppin AGObesity. In: Walker WA, Goulet O, Kleinman RE, et al, eds. Pediatric Gastrointestinal Disease: Pathophysiology, Diagnosis, Management. 4th ed. Ontario, Canada: BC Decker; 2004:311.
11.
Daniels SR, Arnett DK, Eckel RH, et al. Overweight in children and adolescents: pathophysiology, consequences, prevention, and treatment. Circulation. 2005 ;111:1999.
12.
Baker S., Barlow S., Cochran W., et al. Overweight children and adolescents: a clinical report of the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition . J Pediatr Gastroenterol Nutr.2005;40:533.
13.
US Department of Health and Human Services (HHS), US Department of Agriculture (USDA).Dietary Guidelines for Americans, 2005. Washington, DC: US Government Printing Office; 2005. Available at: www.healthierus.gov/dietaryguidelines/. Accessed October 4, 2007.
