# Childhood Obesity — GCMD Library living collection

Everything in the library about childhood obesity — built automatically from dossiers that name it.

Updated: n/a · 3 episodes · 78 cited statements

## Episodes
### Diagnosis & Workup
- [Making the Assessment, Management and Treatment of Obesity Come Alive in Your...](https://qa.library.globalcastmd.com/watch/making-the-assessment-management-and-treatment-of-obesity-come-alive-in-your-865) — video · 46:57 · [machine version](https://qa.library.globalcastmd.com/watch/making-the-assessment-management-and-treatment-of-obesity-come-alive-in-your-865.md)

### Nutritional Management
- [How early can we start? Early Childhood Feeding Practices and How to...](https://qa.library.globalcastmd.com/watch/how-early-can-we-start-early-childhood-feeding-practices-and-how-to-867) — video · 43:47 · [machine version](https://qa.library.globalcastmd.com/watch/how-early-can-we-start-early-childhood-feeding-practices-and-how-to-867.md)

### Patient & Family Education
- [Weight Bias: Child & Adolescent Obesity 2015](https://qa.library.globalcastmd.com/watch/weight-bias-child-adolescent-obesity-2015-863) — video · 34:43 · [machine version](https://qa.library.globalcastmd.com/watch/weight-bias-child-adolescent-obesity-2015-863.md)

## Chapters
- [0:00](https://qa.library.globalcastmd.com/watch/weight-bias-child-adolescent-obesity-2015-863?t=0) Introduction: Passion, Patience, and Personal Experience in Obesity Care (Ep 1)
- [7:00](https://qa.library.globalcastmd.com/watch/weight-bias-child-adolescent-obesity-2015-863?t=420) Defining Stigma, Bias, and Their Origins in Media and Public Health (Ep 1)
- [15:00](https://qa.library.globalcastmd.com/watch/weight-bias-child-adolescent-obesity-2015-863?t=900) Socio-Ecological Model and Visual Recognition Challenges (Ep 1)
- [20:00](https://qa.library.globalcastmd.com/watch/weight-bias-child-adolescent-obesity-2015-863?t=1200) Prevalence and Consequences of Weight Bias (Ep 1)
- [25:00](https://qa.library.globalcastmd.com/watch/weight-bias-child-adolescent-obesity-2015-863?t=1500) Healthcare Provider Bias and Clinical Environment Modifications (Ep 1)
- [28:30](https://qa.library.globalcastmd.com/watch/weight-bias-child-adolescent-obesity-2015-863?t=1710) Q&A: Addressing Weight Bias and Advocacy Strategies (Ep 1)
- [0:00](https://qa.library.globalcastmd.com/watch/making-the-assessment-management-and-treatment-of-obesity-come-alive-in-your-865?t=0) Introduction and Institute Mission (Ep 2)
- [7:00](https://qa.library.globalcastmd.com/watch/making-the-assessment-management-and-treatment-of-obesity-come-alive-in-your-865?t=420) Algorithm Development and Rationale (Ep 2)
- [13:00](https://qa.library.globalcastmd.com/watch/making-the-assessment-management-and-treatment-of-obesity-come-alive-in-your-865?t=780) Assessment Framework: Behaviors and Weight Classification (Ep 2)
- [18:00](https://qa.library.globalcastmd.com/watch/making-the-assessment-management-and-treatment-of-obesity-come-alive-in-your-865?t=1080) Healthy Weight Category Management (Ep 2)
- [23:00](https://qa.library.globalcastmd.com/watch/making-the-assessment-management-and-treatment-of-obesity-come-alive-in-your-865?t=1380) Overweight Category: Augmented Assessment (Ep 2)
- [32:00](https://qa.library.globalcastmd.com/watch/making-the-assessment-management-and-treatment-of-obesity-come-alive-in-your-865?t=1920) Obese Category and Laboratory Screening (Ep 2)
- [36:00](https://qa.library.globalcastmd.com/watch/making-the-assessment-management-and-treatment-of-obesity-come-alive-in-your-865?t=2160) Obesity-Related Comorbidities (Ep 2)
- [40:00](https://qa.library.globalcastmd.com/watch/making-the-assessment-management-and-treatment-of-obesity-come-alive-in-your-865?t=2400) Stage 1: Prevention Plus (Ep 2)
- [42:00](https://qa.library.globalcastmd.com/watch/making-the-assessment-management-and-treatment-of-obesity-come-alive-in-your-865?t=2520) Stage 2: Structured Weight Management (Ep 2)
- [44:00](https://qa.library.globalcastmd.com/watch/making-the-assessment-management-and-treatment-of-obesity-come-alive-in-your-865?t=2640) Stage 3: Comprehensive Multidisciplinary Intervention (Ep 2)
- [46:00](https://qa.library.globalcastmd.com/watch/making-the-assessment-management-and-treatment-of-obesity-come-alive-in-your-865?t=2760) Stage 4: Tertiary Care Intervention and Implementation Resources (Ep 2)
- [0:00](https://qa.library.globalcastmd.com/watch/how-early-can-we-start-early-childhood-feeding-practices-and-how-to-867?t=0) Introduction and Prenatal Nutrition Counseling (Ep 3)
- [8:04](https://qa.library.globalcastmd.com/watch/how-early-can-we-start-early-childhood-feeding-practices-and-how-to-867?t=484) Pregnancy Calorie Needs and Physical Activity (Ep 3)
- [11:50](https://qa.library.globalcastmd.com/watch/how-early-can-we-start-early-childhood-feeding-practices-and-how-to-867?t=710) Early Infancy Feeding (0-6 months) (Ep 3)
- [20:15](https://qa.library.globalcastmd.com/watch/how-early-can-we-start-early-childhood-feeding-practices-and-how-to-867?t=1215) Late Infancy Solid Introduction (6-12 months) (Ep 3)
- [27:54](https://qa.library.globalcastmd.com/watch/how-early-can-we-start-early-childhood-feeding-practices-and-how-to-867?t=1674) Toddler Feeding Strategies (1-3 years) (Ep 3)
- [36:55](https://qa.library.globalcastmd.com/watch/how-early-can-we-start-early-childhood-feeding-practices-and-how-to-867?t=2215) Preschool Age and Conclusion (Ep 3)

## Statements
Every statement is attributed, typed, and timestamped; the link is the citation.
- Using guilt, shame, and blame does not motivate individuals to make healthy changes and instead makes them less likely to improve or more likely to worsen. — Steve (clinical) [Ep 1 · 19:40](https://qa.library.globalcastmd.com/watch/weight-bias-child-adolescent-obesity-2015-863?t=1180)
- Clinical waiting rooms must have chairs that can accommodate larger patients and parents, as chairs with handrails may be too small for some families to sit comfortably. — Steve (guideline) [Ep 1 · 25:50](https://qa.library.globalcastmd.com/watch/weight-bias-child-adolescent-obesity-2015-863?t=1550)
- Examination tables should be checked for weight capacity; some older tables only support up to 350 pounds. — Steve (guideline) [Ep 1 · 26:30](https://qa.library.globalcastmd.com/watch/weight-bias-child-adolescent-obesity-2015-863?t=1590)
- Clinical scales must be able to measure the patient's weight and should be located in a private area rather than an open office space. — Steve (guideline) [Ep 1 · 27:30](https://qa.library.globalcastmd.com/watch/weight-bias-child-adolescent-obesity-2015-863?t=1650)
- Bathroom toilets should be checked for weight capacity and accessibility for patients to get up and down safely. — Steve (guideline) [Ep 1 · 27:20](https://qa.library.globalcastmd.com/watch/weight-bias-child-adolescent-obesity-2015-863?t=1640)
- The term 'obesity' can cause damage and hurt to patients, so it should be used sensitively as a medical diagnosis without intending guilt or blame. — Steve (opinion) [Ep 1 · 6:00](https://qa.library.globalcastmd.com/watch/weight-bias-child-adolescent-obesity-2015-863?t=360)
- A patient-centered, empowering approach utilizing motivational interviewing techniques can save time, improve clinical impact, and create more pleasant encounters for providers. — Steve (clinical) [Ep 1 · 28:10](https://qa.library.globalcastmd.com/watch/weight-bias-child-adolescent-obesity-2015-863?t=1690)
- Parents often do not recognize their child's obesity because weight gain happens gradually, and they should not be blamed when they don't see it themselves. (clinical) [Ep 1 · 30:47](https://qa.library.globalcastmd.com/watch/weight-bias-child-adolescent-obesity-2015-863?t=1847)
- The American Academy of Pediatrics will be releasing a policy statement regarding weight bias in the next couple of years. — Steve (guideline) [Ep 1 · 29:30](https://qa.library.globalcastmd.com/watch/weight-bias-child-adolescent-obesity-2015-863?t=1770)
- The solution to the obesity epidemic is not in the doctor's office alone, but the doctor's office has to be part of the solution. — Steve (opinion) [Ep 1 · 19:20](https://qa.library.globalcastmd.com/watch/weight-bias-child-adolescent-obesity-2015-863?t=1160)
- Children's nutrition habits start very early, and interventions before age 2 can prevent obesity from developing in the first place. — Natalie (clinical) [Ep 3 · 0:00](https://qa.library.globalcastmd.com/watch/how-early-can-we-start-early-childhood-feeding-practices-and-how-to-867?t=0)
- About 40% of 2nd and 5th graders consume zero vegetables on any given day. — Natalie (epidemiological) [Ep 3 · 1:00](https://qa.library.globalcastmd.com/watch/how-early-can-we-start-early-childhood-feeding-practices-and-how-to-867?t=60)
- About one out of 5 children and teenagers eat the recommended 5 servings per day of vegetables and fruits, with french fries counting as about a quarter of those servings. — Natalie (epidemiological) [Ep 3 · 1:00](https://qa.library.globalcastmd.com/watch/how-early-can-we-start-early-childhood-feeding-practices-and-how-to-867?t=60)
- About a third of toddlers don't eat any fruit each day, but they are eating baked desserts, candy, and sweetened beverages. — Natalie (epidemiological) [Ep 3 · 1:00](https://qa.library.globalcastmd.com/watch/how-early-can-we-start-early-childhood-feeding-practices-and-how-to-867?t=60)
- By the time a child enters elementary school, food preferences are already very well established. — Natalie (clinical) [Ep 3 · 2:00](https://qa.library.globalcastmd.com/watch/how-early-can-we-start-early-childhood-feeding-practices-and-how-to-867?t=120)
- Women who gain excessive weight during pregnancy are more likely to develop gestational diabetes, and children born to mothers with gestational diabetes are more likely to suffer from obesity and complications later. — Natalie (clinical) [Ep 3 · 3:00](https://qa.library.globalcastmd.com/watch/how-early-can-we-start-early-childhood-feeding-practices-and-how-to-867?t=180)
- No extra calories are needed in the first trimester of pregnancy, about 350 extra calories in the second trimester, and about 450 extra calories in the third trimester. — Natalie (guideline) [Ep 3 · 4:00](https://qa.library.globalcastmd.com/watch/how-early-can-we-start-early-childhood-feeding-practices-and-how-to-867?t=240)
- Pregnant women often misunderstand calorie needs; a salad at a fast food restaurant is typically 750-800 calories, not the 350 extra calories needed in second trimester. (clinical) [Ep 3 · 8:04](https://qa.library.globalcastmd.com/watch/how-early-can-we-start-early-childhood-feeding-practices-and-how-to-867?t=484)
- Pregnant women should get at least 150 minutes of exercise per week, the same as the general population recommendation. — Natalie (guideline) [Ep 3 · 11:50](https://qa.library.globalcastmd.com/watch/how-early-can-we-start-early-childhood-feeding-practices-and-how-to-867?t=710)
- If a pregnant woman is already physically active, she should continue that activity; if previously inactive, it is safe to begin basic physical activity during pregnancy. — Natalie (guideline) [Ep 3 · 11:50](https://qa.library.globalcastmd.com/watch/how-early-can-we-start-early-childhood-feeding-practices-and-how-to-867?t=710)
- AAP recommends exclusive breastfeeding to 6 months and not introducing solids until 6 months, or at minimum not earlier than 4 months. — Natalie (guideline) [Ep 3 · 12:35](https://qa.library.globalcastmd.com/watch/how-early-can-we-start-early-childhood-feeding-practices-and-how-to-867?t=755)
- Children who are introduced to solid foods before 4 months have an increased risk of developing childhood obesity later. — Natalie (clinical) [Ep 3 · 12:35](https://qa.library.globalcastmd.com/watch/how-early-can-we-start-early-childhood-feeding-practices-and-how-to-867?t=755)
- Flavors pass through amniotic fluid to the baby during pregnancy and through breast milk during breastfeeding, providing early flavor exposure. — Natalie (clinical) [Ep 3 · 13:35](https://qa.library.globalcastmd.com/watch/how-early-can-we-start-early-childhood-feeding-practices-and-how-to-867?t=815)
- Babies who are breastfed are more likely to try a variety of different foods later, possibly related to early exposure to diverse flavors through breast milk. — Natalie (clinical) [Ep 3 · 13:35](https://qa.library.globalcastmd.com/watch/how-early-can-we-start-early-childhood-feeding-practices-and-how-to-867?t=815)
- Breastfeeding mothers should eat a wide variety of healthy foods including bitter vegetables like broccoli, cauliflower, and Brussels sprouts to expose babies to these flavors early. — Natalie (clinical) [Ep 3 · 14:35](https://qa.library.globalcastmd.com/watch/how-early-can-we-start-early-childhood-feeding-practices-and-how-to-867?t=875)
- Babies who gain weight very rapidly in the first year of life are more likely to have weight problems as children later. — Natalie (clinical) [Ep 3 · 15:35](https://qa.library.globalcastmd.com/watch/how-early-can-we-start-early-childhood-feeding-practices-and-how-to-867?t=935)
- Motor skill development and physical literacy starting from infancy helps predict physical activity levels and health outcomes later in childhood. — Natalie (clinical) [Ep 3 · 16:35](https://qa.library.globalcastmd.com/watch/how-early-can-we-start-early-childhood-feeding-practices-and-how-to-867?t=995)
- Tummy time recommendation is one hour per day or more, which can be done in spurts throughout the day. — Natalie (guideline) [Ep 3 · 16:35](https://qa.library.globalcastmd.com/watch/how-early-can-we-start-early-childhood-feeding-practices-and-how-to-867?t=995)
- Current guidelines do not recommend waiting to introduce potentially allergenic foods like fish, eggs, and nuts; the type of solid food introduced first does not make a significant difference. — Natalie (guideline) [Ep 3 · 20:15](https://qa.library.globalcastmd.com/watch/how-early-can-we-start-early-childhood-feeding-practices-and-how-to-867?t=1215)
- Babies have somewhat immature taste buds in the first year, which makes them more willing to try and accept a wide variety of foods including bitter flavors. — Natalie (clinical) [Ep 3 · 27:54](https://qa.library.globalcastmd.com/watch/how-early-can-we-start-early-childhood-feeding-practices-and-how-to-867?t=1674)
- When babies appear to spit out food, it may be their extrusion reflex rather than rejection of the food. — Natalie (clinical) [Ep 3 · 27:54](https://qa.library.globalcastmd.com/watch/how-early-can-we-start-early-childhood-feeding-practices-and-how-to-867?t=1674)
- Neophobia (fear of trying new things) is a normal developmental milestone that almost every toddler goes through. — Natalie (clinical) [Ep 3 · 28:54](https://qa.library.globalcastmd.com/watch/how-early-can-we-start-early-childhood-feeding-practices-and-how-to-867?t=1734)
- In authoritative feeding (division of responsibility), parents decide what foods are offered, when they are offered, and where they are offered; the child decides what to eat and how much to eat from what is offered. — Natalie (clinical) [Ep 3 · 29:54](https://qa.library.globalcastmd.com/watch/how-early-can-we-start-early-childhood-feeding-practices-and-how-to-867?t=1794)
- Family meals eaten together at least 3 times per week provide health benefits and help children adopt healthier eating habits through modeling. — Natalie (clinical) [Ep 3 · 30:54](https://qa.library.globalcastmd.com/watch/how-early-can-we-start-early-childhood-feeding-practices-and-how-to-867?t=1854)
- Children are naturally good at self-regulating food intake if allowed to do so, but they unlearn this ability when forced to clean plates, when food is used as reward, or when eating is used for comfort. — Natalie (clinical) [Ep 3 · 31:54](https://qa.library.globalcastmd.com/watch/how-early-can-we-start-early-childhood-feeding-practices-and-how-to-867?t=1914)
- Studies show that children as young as 3 years old lose their ability to self-regulate food intake due to parental feeding practices like forcing, bribing, or using food as comfort. — Natalie (clinical) [Ep 3 · 31:54](https://qa.library.globalcastmd.com/watch/how-early-can-we-start-early-childhood-feeding-practices-and-how-to-867?t=1914)
- It takes 15 to 20 taste exposures for a child to come to like a new food. — Natalie (clinical) [Ep 3 · 36:55](https://qa.library.globalcastmd.com/watch/how-early-can-we-start-early-childhood-feeding-practices-and-how-to-867?t=2215)
- Taste buds are on the tongue, so a child does not need to swallow food to get the benefit of taste exposure; just tasting counts toward the 15-20 exposures needed. — Natalie (clinical) [Ep 3 · 36:55](https://qa.library.globalcastmd.com/watch/how-early-can-we-start-early-childhood-feeding-practices-and-how-to-867?t=2215)
- Engaging children in food preparation (cooking together, gardening, grocery shopping) makes them more willing to try new foods. — Natalie (clinical) [Ep 3 · 37:55](https://qa.library.globalcastmd.com/watch/how-early-can-we-start-early-childhood-feeding-practices-and-how-to-867?t=2275)
- Peer influence is powerful for food acceptance; a picky eater may be more willing to try foods when eating with an adventurous-eating peer. — Natalie (clinical) [Ep 3 · 38:55](https://qa.library.globalcastmd.com/watch/how-early-can-we-start-early-childhood-feeding-practices-and-how-to-867?t=2335)
- Children with overweight and obesity may be sick and are often not being appropriately screened for comorbidities. — Corey (clinical) [Ep 2 · 3:00](https://qa.library.globalcastmd.com/watch/making-the-assessment-management-and-treatment-of-obesity-come-alive-in-your-865?t=180)
- The algorithm was developed using 2007 Expert Committee recommendations, US Department of Health and Human Services cardiovascular guidelines, and American Diabetes Association guidelines. — Corey (guideline) [Ep 2 · 8:00](https://qa.library.globalcastmd.com/watch/making-the-assessment-management-and-treatment-of-obesity-come-alive-in-your-865?t=480)
- The algorithm starts at the well child visit and continues with planned follow-up visits as determined by the patient, family, and provider. — Corey (guideline) [Ep 2 · 11:00](https://qa.library.globalcastmd.com/watch/making-the-assessment-management-and-treatment-of-obesity-come-alive-in-your-865?t=660)
- The algorithm is not a protocol but a suggested course of action to be used with clinical judgment. — Corey (guideline) [Ep 2 · 11:30](https://qa.library.globalcastmd.com/watch/making-the-assessment-management-and-treatment-of-obesity-come-alive-in-your-865?t=690)
- The algorithm applies to patients 2 years and older, not addressing the birth to 2 years age group. — Corey (guideline) [Ep 2 · 13:00](https://qa.library.globalcastmd.com/watch/making-the-assessment-management-and-treatment-of-obesity-come-alive-in-your-865?t=780)
- For healthy weight children (BMI 5th-84th percentile), providers should screen for genetic dyslipidemia with non-fasting lipid profile at ages 9-11 and 18-21, independent of weight status. — Corey (guideline) [Ep 2 · 19:00](https://qa.library.globalcastmd.com/watch/making-the-assessment-management-and-treatment-of-obesity-come-alive-in-your-865?t=1140)
- Screening for genetic dyslipidemia is part of cardiovascular guidelines from approximately 3 years ago and should be done on all patients irrespective of weight. — Corey (guideline) [Ep 2 · 20:00](https://qa.library.globalcastmd.com/watch/making-the-assessment-management-and-treatment-of-obesity-come-alive-in-your-865?t=1200)
- An augmented review of systems for children ≥85th percentile should assess for snoring, sleep disturbances, abdominal pain, menstrual irregularities, hip/knee/leg pain, polyuria, polydipsia, and depression as indicators of potential comorbidities. — Corey (clinical) [Ep 2 · 25:00](https://qa.library.globalcastmd.com/watch/making-the-assessment-management-and-treatment-of-obesity-come-alive-in-your-865?t=1500)
- Snoring in children with elevated BMI may indicate obstructive sleep apnea. — Corey (clinical) [Ep 2 · 26:00](https://qa.library.globalcastmd.com/watch/making-the-assessment-management-and-treatment-of-obesity-come-alive-in-your-865?t=1560)
- Abdominal pain in children with elevated BMI may indicate gastroesophageal reflux, constipation, gallbladder disease, or non-alcoholic fatty liver disease. — Corey (clinical) [Ep 2 · 26:30](https://qa.library.globalcastmd.com/watch/making-the-assessment-management-and-treatment-of-obesity-come-alive-in-your-865?t=1590)
- Polyuria and polydipsia in children with elevated BMI may indicate type 2 diabetes. — Corey (clinical) [Ep 2 · 27:00](https://qa.library.globalcastmd.com/watch/making-the-assessment-management-and-treatment-of-obesity-come-alive-in-your-865?t=1620)
- Physical exam findings requiring attention in children with elevated BMI include blood pressure (with correct cuff size), acanthosis nigricans, tonsillar hypertrophy, goiter, abdominal tenderness, hepatomegaly, bowing of legs (Blount disease), limited hip range of motion (slipped capital femoral epiphysis), fuzzy optic discs (pseudotumor cerebri), acne, and skin inflammation. — Corey (clinical) [Ep 2 · 28:00](https://qa.library.globalcastmd.com/watch/making-the-assessment-management-and-treatment-of-obesity-come-alive-in-your-865?t=1680)
- Correct blood pressure cuff size is critically important for children with obesity. — Corey (clinical) [Ep 2 · 29:00](https://qa.library.globalcastmd.com/watch/making-the-assessment-management-and-treatment-of-obesity-come-alive-in-your-865?t=1740)
- Family history assessment for children with elevated BMI should include obesity, type 2 diabetes, hypertension, lipid abnormalities, and heart disease in first and second-degree relatives. — Corey (clinical) [Ep 2 · 31:00](https://qa.library.globalcastmd.com/watch/making-the-assessment-management-and-treatment-of-obesity-come-alive-in-your-865?t=1860)
- Children in the overweight category (85th-94th percentile) with positive family history, review of systems, or physical exam findings should receive laboratory screening for comorbidities. — Corey (guideline) [Ep 2 · 33:00](https://qa.library.globalcastmd.com/watch/making-the-assessment-management-and-treatment-of-obesity-come-alive-in-your-865?t=1980)
- All children with BMI ≥95th percentile should have additional screening and workup for underlying comorbidities regardless of symptoms. — Corey (guideline) [Ep 2 · 34:00](https://qa.library.globalcastmd.com/watch/making-the-assessment-management-and-treatment-of-obesity-come-alive-in-your-865?t=2040)
- Some providers obtain non-fasting labs for patient convenience, though fasting labs are preferred; this is particularly relevant in rural areas where return visits are unlikely. — Corey (clinical) [Ep 2 · 37:00](https://qa.library.globalcastmd.com/watch/making-the-assessment-management-and-treatment-of-obesity-come-alive-in-your-865?t=2220)
- Some subspecialty clinics screen for vitamin D deficiency and insulin resistance with vitamin D and fasting insulin levels, but the clinical utility and cost-effectiveness of these tests is yet to be determined. — Corey (clinical) [Ep 2 · 38:00](https://qa.library.globalcastmd.com/watch/making-the-assessment-management-and-treatment-of-obesity-come-alive-in-your-865?t=2280)
- There are no current guidelines on when to start laboratory testing for patients with obesity; based on health risks, some experts may start screening as early as 2 years of age. — Corey (guideline) [Ep 2 · 39:00](https://qa.library.globalcastmd.com/watch/making-the-assessment-management-and-treatment-of-obesity-come-alive-in-your-865?t=2340)
- Constipation is a very common comorbidity in children with obesity that is easily treated and improves patients' ability to eat more and be more physically active. — Corey (clinical) [Ep 2 · 40:00](https://qa.library.globalcastmd.com/watch/making-the-assessment-management-and-treatment-of-obesity-come-alive-in-your-865?t=2400)
- Not every patient is ready for obesity treatment; when patients and families are not ready, providers should avoid using fear tactics and instead keep the door open for future engagement. — Corey (clinical) [Ep 2 · 42:00](https://qa.library.globalcastmd.com/watch/making-the-assessment-management-and-treatment-of-obesity-come-alive-in-your-865?t=2520)
- There are no quick fixes for childhood obesity; surgical treatment for eligible older children requires many months of behavior modification before surgery. — Corey (clinical) [Ep 2 · 43:00](https://qa.library.globalcastmd.com/watch/making-the-assessment-management-and-treatment-of-obesity-come-alive-in-your-865?t=2580)
- Motivational interviewing works for behavior change and has been shown to work for obesity management and treatment. — Corey (clinical) [Ep 2 · 44:00](https://qa.library.globalcastmd.com/watch/making-the-assessment-management-and-treatment-of-obesity-come-alive-in-your-865?t=2640)
- Small behavior changes can have profound effects on health and are usually more sustainable than large changes. — Corey (clinical) [Ep 2 · 45:00](https://qa.library.globalcastmd.com/watch/making-the-assessment-management-and-treatment-of-obesity-come-alive-in-your-865?t=2700)
- In pediatrics, children will continue to grow taller until growth plates fuse, which is an advantage in obesity management. — Corey (clinical) [Ep 2 · 46:00](https://qa.library.globalcastmd.com/watch/making-the-assessment-management-and-treatment-of-obesity-come-alive-in-your-865?t=2760)
- Patients should start at the least intensive treatment stage and advance based on response to treatment, age, BMI, health risks, and most importantly patient/family motivation. — Corey (guideline) [Ep 2 · 47:00](https://qa.library.globalcastmd.com/watch/making-the-assessment-management-and-treatment-of-obesity-come-alive-in-your-865?t=2820)
- An empathetic, empowering counseling style such as motivational interviewing should be employed to empower patients and families in behavior change, avoiding fear tactics. — Corey (guideline) [Ep 2 · 48:00](https://qa.library.globalcastmd.com/watch/making-the-assessment-management-and-treatment-of-obesity-come-alive-in-your-865?t=2880)
- Stage 1 (Prevention Plus) consists of 15-20 minute themed follow-up visits in primary care focusing on behaviors chosen by patient/family, with possible partnerships with dietitian, social worker, athletic trainer, or physical therapist. — Corey (guideline) [Ep 2 · 46:57](https://qa.library.globalcastmd.com/watch/making-the-assessment-management-and-treatment-of-obesity-come-alive-in-your-865?t=2817)
- For Stage 1, children ages 2-5 with obesity should not lose more than 1 pound per month, and older children/adolescents should not lose more than an average of 2 pounds per week. — Corey (guideline) [Ep 2 · 46:57](https://qa.library.globalcastmd.com/watch/making-the-assessment-management-and-treatment-of-obesity-come-alive-in-your-865?t=2817)
- Monthly follow-up visits are recommended for Stage 1, though follow-up should be tailored to patient/family motivation and can include text, email, or social media contact. — Corey (guideline) [Ep 2 · 46:57](https://qa.library.globalcastmd.com/watch/making-the-assessment-management-and-treatment-of-obesity-come-alive-in-your-865?t=2817)
- After 3-6 months in Stage 1, if BMI and weight status do not improve, consider advancing to Stage 2. — Corey (guideline) [Ep 2 · 46:57](https://qa.library.globalcastmd.com/watch/making-the-assessment-management-and-treatment-of-obesity-come-alive-in-your-865?t=2817)
- Stage 2 (Structured Weight Management) is delivered by primary care providers with appropriate training, particularly in motivational interviewing, with more intensive support than Stage 1. — Corey (guideline) [Ep 2 · 46:57](https://qa.library.globalcastmd.com/watch/making-the-assessment-management-and-treatment-of-obesity-come-alive-in-your-865?t=2817)
- Stage 2 follow-up should occur every 2-4 weeks as determined by patient, family, and physician. — Corey (guideline) [Ep 2 · 46:57](https://qa.library.globalcastmd.com/watch/making-the-assessment-management-and-treatment-of-obesity-come-alive-in-your-865?t=2817)
- Stage 3 (Comprehensive Multidisciplinary Intervention) is delivered by pediatric weight management clinics with multidisciplinary teams that may include endocrinologists, pulmonologists, gastroenterologists, social workers, and dietitians. — Corey (guideline) [Ep 2 · 46:57](https://qa.library.globalcastmd.com/watch/making-the-assessment-management-and-treatment-of-obesity-come-alive-in-your-865?t=2817)
- Stage 3 includes structured behavior modification with food and activity monitoring and development of short-term diet and physical activity goals. — Corey (guideline) [Ep 2 · 46:57](https://qa.library.globalcastmd.com/watch/making-the-assessment-management-and-treatment-of-obesity-come-alive-in-your-865?t=2817)
- Stage 4 (Tertiary Care Intervention) is for patients >95th percentile with significant comorbidities, delivered at pediatric weight management centers with obesity expertise. — Corey (guideline) [Ep 2 · 46:57](https://qa.library.globalcastmd.com/watch/making-the-assessment-management-and-treatment-of-obesity-come-alive-in-your-865?t=2817)
- Stage 4 includes intensive diet and activity counseling with consideration of medications and age-appropriate surgery. — Corey (guideline) [Ep 2 · 46:57](https://qa.library.globalcastmd.com/watch/making-the-assessment-management-and-treatment-of-obesity-come-alive-in-your-865?t=2817)
- The goal of Stage 4 is BMI decrease because these children are sick and need to reduce BMI, though behavior change remains the initial focus. — Corey (guideline) [Ep 2 · 46:57](https://qa.library.globalcastmd.com/watch/making-the-assessment-management-and-treatment-of-obesity-come-alive-in-your-865?t=2817)

## Host summaries
Recaps by a host of what the experts said — not the host's own clinical position.
- Weight bias has increased substantially over the last decade since 2006 and rates continue to rise according to UConn Rudd Center research. — Steve summarizing the discussion [Ep 1 · 15:00](https://qa.library.globalcastmd.com/watch/weight-bias-child-adolescent-obesity-2015-863?t=900)
- Women experience weight bias more than men, and individuals with more severe obesity experience more bias. — Steve summarizing the discussion [Ep 1 · 15:20](https://qa.library.globalcastmd.com/watch/weight-bias-child-adolescent-obesity-2015-863?t=920)
- Children experience weight bias from peers, family members, and healthcare professionals. — Steve summarizing the discussion [Ep 1 · 15:40](https://qa.library.globalcastmd.com/watch/weight-bias-child-adolescent-obesity-2015-863?t=940)
- Healthcare professionals are some of the worst offenders of weight bias as experienced by patients according to research studies. — Steve summarizing the discussion [Ep 1 · 20:00](https://qa.library.globalcastmd.com/watch/weight-bias-child-adolescent-obesity-2015-863?t=1200)
- Physicians view patients with obesity as noncompliant, dishonest, lazy, lacking self-control, weak-willed, unintelligent, and unsuccessful. — Steve summarizing the discussion [Ep 1 · 21:40](https://qa.library.globalcastmd.com/watch/weight-bias-child-adolescent-obesity-2015-863?t=1300)
- 31% of nurses said they would prefer not to care for individuals affected by obesity. — Steve summarizing the discussion [Ep 1 · 22:30](https://qa.library.globalcastmd.com/watch/weight-bias-child-adolescent-obesity-2015-863?t=1350)
- 24% of nurses said that folks with obesity repulse them. — Steve summarizing the discussion [Ep 1 · 22:45](https://qa.library.globalcastmd.com/watch/weight-bias-child-adolescent-obesity-2015-863?t=1365)
- Psychologists endorse that patients with obesity have more pathology, more severe symptoms, negative family qualities, and worse prognosis on initial assessment. — Steve summarizing the discussion [Ep 1 · 23:40](https://qa.library.globalcastmd.com/watch/weight-bias-child-adolescent-obesity-2015-863?t=1420)
- Individuals experiencing weight bias have higher levels of depression, anxiety, low self-esteem, and poor body image. — Steve summarizing the discussion [Ep 1 · 18:20](https://qa.library.globalcastmd.com/watch/weight-bias-child-adolescent-obesity-2015-863?t=1100)
- Weight bias leads to less preventative health services, fewer exams, more appointment cancellations, and delays in healthcare access. — Steve summarizing the discussion [Ep 1 · 19:10](https://qa.library.globalcastmd.com/watch/weight-bias-child-adolescent-obesity-2015-863?t=1150)
- Healthcare providers cannot visually identify which children fall into obesity risk categories without calculating BMI percentile. — Steve summarizing the discussion [Ep 1 · 12:30](https://qa.library.globalcastmd.com/watch/weight-bias-child-adolescent-obesity-2015-863?t=750)
- A child at 55th percentile BMI, 75th percentile, and obese category cannot be reliably distinguished visually by healthcare providers due to the high prevalence of childhood obesity. — Steve summarizing the discussion [Ep 1 · 11:40](https://qa.library.globalcastmd.com/watch/weight-bias-child-adolescent-obesity-2015-863?t=700)
- For patients with BMI over the 85th percentile, the 2007 Expert Committee recommendations state providers should have a 'pausing moment' because these children could be sick. — Corey summarizing the discussion [Ep 2 · 23:00](https://qa.library.globalcastmd.com/watch/making-the-assessment-management-and-treatment-of-obesity-come-alive-in-your-865?t=1380)
- The 2007 Expert Committee recommendations state that fasting glucose, fasting lipid profile, ALT, and AST should be obtained in patients with BMI ≥85th percentile with risk factors and all patients with BMI ≥95th percentile. — Corey summarizing the discussion [Ep 2 · 35:00](https://qa.library.globalcastmd.com/watch/making-the-assessment-management-and-treatment-of-obesity-come-alive-in-your-865?t=2100)
- ADA and Endocrine Society guidelines recommend hemoglobin A1c, fasting glucose, or oral glucose tolerance test to screen for diabetes or prediabetes in children with obesity. — Corey summarizing the discussion [Ep 2 · 36:00](https://qa.library.globalcastmd.com/watch/making-the-assessment-management-and-treatment-of-obesity-come-alive-in-your-865?t=2160)
- The Children's Hospital Association consensus statements on comorbidity management may help keep children in their medical home and provide guidance to sites without subspecialists. — Corey summarizing the discussion [Ep 2 · 41:00](https://qa.library.globalcastmd.com/watch/making-the-assessment-management-and-treatment-of-obesity-come-alive-in-your-865?t=2460)

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