Obesity in children and adolescents is now the most common chronic condition in the USA. Data indicate that approximately one in five children in the USA is now overweight. Public health professionals have increased efforts in recent years to develop medically supervised programs for this population. However, research shows that only a small amount of obese children participate in weight-reduction programs. Also, the long-term effects of these weight-reduction interventions for obese children have not been well researched. Several recent studies report that most of the successful obesity programs utilize an interdisciplinary approach that combines a diet, physical activity, parental involvement and behavioral modification. This article provides a review of the professional literature related to the benefits and barriers of medically supervised pediatric weight-management programs. It summarizes the programs that work and the perceived barriers that parents and families struggle with in adhering to treatment plans.
American Diabetes Association (2000) `Type 2 Diabetes in Children and Adolescents', Pediatrics105(3): 671-80.
2.
Anderson, P. and Butcher, K. (2006) `Childhood Obesity: Trends and Potential Causes' , The Future of Children16(1): 19-45.
3.
Barlow, S., Dietz, W., Klish, W. and Trowbridge, F. (2002) `Treatment of Child and Adolescent Obesity: Reports from Pediatricians, Pediatric Nurse Practitioners and Registered Dietitians' , Pediatrics110(1): 229-32.
4.
Braet, C. (2006) `Patient Characteristics as Predictors of Weight Loss after Obesity Treatment for Children', Obesity14(1): 148-55.
5.
Caprio, S. (2006) `Treating Child Obesity and Associated Medical Conditions', The Future of Children16(1): 209-24.
6.
Centers for Disease Control and Prevention ( 2003) `Prevalence of Overweight Children and Adolescents: USA Department of Health and Human Services', URL (consulted 21 June 2007): http://www.cdc.gov/nchs/products/pubs/pubd/hestats/overwght99.htm
7.
Centers for Disease Control and Prevention ( 2006a) `U.S. Obesity Trends 1985-2006', United States Department of Health and Human Services, URL (consulted 6 August 2008): http://www.cdc/.gov/nccdphd/dnpa/obesity/trend/map
8.
Centers for Disease Control and Prevention ( 2006b) `Youth Risk Behavior Surveillance', Morbidity and Mortality Weekly Report 55(5): 1-108.
9.
Cote, M., Byexkowski, T., Kotagal, U., Kirk, S., Zeller, M. and Daniels, S. (2004) `Service Quality and Attrition: an Examination of a Pediatric Obesity Program', International Journal for Quality in Health Care16(2): 165-73.
10.
Dietz, W. (1998) `Health Consequences of Obesity in Youth: Childhood Predictors of Adult Disease', Pediatrics101(3): 518-24.
11.
Eaton, D., Kann, L., Kinchen, S., Ross, J., Hawkins, J. and Harris, W. (2006) `Youth Risk Behavior Surveillance: USA 2005', Journal of School Health76(7): 353-72.
12.
Epstein, L. and Wing, R. (1987) `Behavioral Treatment of Childhood Obesity', Psychological Bulletin101(3): 331-42.
13.
Epstein, L., Valoski, A., Wing, R. and McCurley, P. (1990) `Ten-year Follow-up of Behavioral, Family-based Treatment for Obese Children', Journal of American Medical Association264(19): 2519-23.
14.
Fowler, F.J., Gallagher, P.M. and Nederend, S. (1999) `Comparing Telephone and Mail Responses to the CAHPS Survey Instrument', Medical Care37(supp.): 2591-8.
15.
Goldberg, J. and Kiernan, M. (2005) `Innovative Techniques to Address Retention in a Behavioral Weight-loss Trial', Health Education Research20(4): 292-8.
16.
Harris-Kojetin, L.D., Fowler, F.J., Brown, J.A., Schnaier, J.A. and Sweeny, S.F. (1999) `The Use of Cognitive Testing of Developing and Evaluating CAHPS I.D. Core Survey Items', Medical Care37(supp.): 447-76.
17.
Homer, C.J., Fowler, F.J., Gallagher, P.M., Shaul, J., Uyeda, M., Zaslavsky, A., Wilson, V. and Cleary, P. (1999) `The Consumer Assessment of Health Plan Study (CAHPS) Survey of Children's Health Care', Joint Commission Journal on Quality Improvement25(7): 369-77.
18.
Honas, J., Early, J., Frederickson, D. and O'Brien, M. (2003) `Predictors of Attrition in Large Clinic-based Weight-loss Program', Obesity Research11: 888-94.
19.
Institute of Medicine (2004) `Preventing Childhood Obesity: Health in the Balance', URL (consulted 25 April 2007): http://www.iom.edu/?=22596&redicrect=0
20.
Institute of Medicine (2006) Progress in Preventing Childhood Obesity: Focus on Communities - Brief Summary . Washington, DC: National Academies Press.
21.
Kaur, H.Hyder, M.L. and Poston W.S. (2003) `Childhood Overweight: an Expanding Problem', Epidemiologic Reviews2(6): 375-88.
22.
National Center for Health Statistics (2002 ) `Prevalence of Overweight among Children and Adolescents: USA, 1999-2000', URL (consulted 21 January 2004): http://www./ede/gpv/mcis/products/pubs/pbd/hestats/overwgght99
23.
National Institute for Health Care Management Foundation (2003) `Childhood Obesity-advancing Effective Prevention and Treatment an Overview for Health Professions Issue Paper', URL (consulted 21 April 2007): http://www.nihcm.org
24.
Nemet, D., Barkan, S., Epstein, V., Friedland, O., Kowen, G. and Eliakin, P. (2005) `Short and Long-term Beneficial Effects of a Combined Dietary-Behavioral-Physical Activity Intervention for the Treatment of Childhood Obesity', Pediatrics115(4): 443-9.
25.
Ogden, C., Flegal, K., Carroll, M. and Johnson, C. (2002) `Prevalence and Trends in Overweight among US Children and Adolescents', Journal of the American Medical Association288(14): 1728-32.
26.
Public Health News Center for Nutrition (2007 ) Obesity Rates Continue to Climb in the United States', Johns Hopkins Bloomberg School of Public Health, July, URL (consulted 6 August 2008): http://www.hsph.edu/publichealthnews/pressreleases2007
27.
Reinehr, R., Brylak, D., Alexy, U., Dersting, M. and Andler, W. (2002) `Predictors to Success in Outpatient Training to Obese Children and Adolescents', International Journal of Obesity27(9): 1087-92.
28.
Teixeria, P., Gong, S., Hourkooper, L., Cssler, E., Metcalfe, L., Blew, R., Sarinha, L. and Lohman, T. (2004) `Pretreatment Predictors of Attrition and Successful Weight Management in Women', International Journal of Obesity28(9): 1124-33.
29.
Tershakovec, A. and Kuppler, K. (2003) `Ethnicity, Insurance Type and Follow-up in a Pediatric Weight-management Program', Obesity Research11(1): 17-20.
30.
US Department of Health and Human Services ( 2001) The Surgeon General's Call to Action to Prevent and Decrease Overweight and Obesity. Rockville, MD: Public Health Service, Office of the Surgeon General.
31.
Wang, Y. and Beydoun, M. (2007) `The Obesity Epidemic in the United States: Gender, Age, Socioeconomic, Racial/Ethnic, and Geographic Characteristics: a Systematic Review and Meta-regression Analysis', Epidemiology Review29(1): 6-28.
32.
White, M., Martin, P., Newton, R., Walden, H., York-Crowe, E., Gordon, S., Ryan, D. and Williamson, D. (2004) `Mediators of Weight Loss in a Family-based Intervention Presented over the Internet', Obesity Research12(7): 1050-9.
33.
Williams, C., Haymna, L., Daniels, S., Robinson, T., Steinberger, J., Paridon, S. and Bazzarre, T. (2002) `Cardiovascular Health in Childhood: a Statement for Health Professionals from the Committee on Atherocsclerosis, Hypertension, and Obesity in the Young of the Council on Cardiovascular Disease in the Young, American Heart Association', Circulation 106(1): 143-60.
34.
World Health Organization (2003) `Childhood Prevention Agenda', URL (consulted 21 January 2007): http://www.commercialalert.org/issues/health/childhoodobesity
35.
Wrotniak, B., Epstein, L., Paluch, R. and Roemmich, J. (2005) `The Relationship between Parent and Child Self-reported Adherence and Weight Loss', Obesity Research13(4): 1089-96.
36.
Zeller, M. (2005) Why Obese Children Often Drop Out of Weight-management Programs. Cincinnati, OH: Children's Hospital Medical Center.
37.
Zeller, M., Kirk, S., Clayton, R., Khoury, P., Grieme, J., Santangeol, M. and Daniels, S. (2004a) `Predictors of Attrition from a Pediatric Weight-management Program', Journal of Pediatrics144(4): 466-70.
38.
Zeller, M., Saelens, B., Raehrig, H., Kirk, S. and Daniels, S. (2004b) `Psychological Adjustment of Obese Youth Presenting for Weight-management Treatment', Obesity12(6): 1576-86.
