# Overweight — GCMD Library living collection

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

Updated: n/a · 4 episodes · 62 cited statements

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

### Evidence & Research
- [Exercise Journal Club: Pediatric Obesity 2017](https://origin-library.globalcastmd.com/watch/exercise-journal-club-pediatric-obesity-2017-370) — video · 25:58 · [machine version](https://origin-library.globalcastmd.com/watch/exercise-journal-club-pediatric-obesity-2017-370.md)
- [Clinical Research Facilitators, Barriers, and Preferences of Parents of Children With Overweight...](https://origin-library.globalcastmd.com/watch/clinical-research-facilitators-barriers-and-preferences-of-parents-of-children-w-13884) — video · 0:41 · [machine version](https://origin-library.globalcastmd.com/watch/clinical-research-facilitators-barriers-and-preferences-of-parents-of-children-w-13884.md)

### Patient & Family Education
- [Taking the Battle Out of Getting Kids to Eat Healthier and Move More: Child &...](https://origin-library.globalcastmd.com/watch/taking-the-battle-out-of-getting-kids-to-eat-healthier-and-move-more-child-862) — video · 1:09:36 · [machine version](https://origin-library.globalcastmd.com/watch/taking-the-battle-out-of-getting-kids-to-eat-healthier-and-move-more-child-862.md)

## Chapters
- [0:00](https://origin-library.globalcastmd.com/watch/exercise-journal-club-pediatric-obesity-2017-370?t=0) Study presentation: Summer versus school-year obesity prevalence growth (Ep 1)
- [12:37](https://origin-library.globalcastmd.com/watch/exercise-journal-club-pediatric-obesity-2017-370?t=757) Clinical approaches to summer activity planning and barriers (Ep 1)
- [18:00](https://origin-library.globalcastmd.com/watch/exercise-journal-club-pediatric-obesity-2017-370?t=1080) ADHD medications, sleep, and weight management considerations (Ep 1)
- [0:00](https://origin-library.globalcastmd.com/watch/taking-the-battle-out-of-getting-kids-to-eat-healthier-and-move-more-child-862?t=0) Introduction: Healthy Habits Over Weight Loss and Parenting Styles (Ep 2)
- [3:57](https://origin-library.globalcastmd.com/watch/taking-the-battle-out-of-getting-kids-to-eat-healthier-and-move-more-child-862?t=237) The Three P's: Parents' Jobs in Feeding and Activity (Ep 2)
- [9:58](https://origin-library.globalcastmd.com/watch/taking-the-battle-out-of-getting-kids-to-eat-healthier-and-move-more-child-862?t=598) The Three C's: Children's Jobs in Feeding and Activity (Ep 2)
- [20:40](https://origin-library.globalcastmd.com/watch/taking-the-battle-out-of-getting-kids-to-eat-healthier-and-move-more-child-862?t=1240) Developmental Stages: Building Healthy Eaters and Active Children (Ep 2)
- [28:22](https://origin-library.globalcastmd.com/watch/taking-the-battle-out-of-getting-kids-to-eat-healthier-and-move-more-child-862?t=1702) Message Makeovers for Feeding (Ep 2)
- [39:26](https://origin-library.globalcastmd.com/watch/taking-the-battle-out-of-getting-kids-to-eat-healthier-and-move-more-child-862?t=2366) Transitioning Older Kids and Teens to Self-Regulation (Ep 2)
- [47:55](https://origin-library.globalcastmd.com/watch/taking-the-battle-out-of-getting-kids-to-eat-healthier-and-move-more-child-862?t=2875) Message Makeovers for Physical Activity (Ep 2)
- [63:00](https://origin-library.globalcastmd.com/watch/taking-the-battle-out-of-getting-kids-to-eat-healthier-and-move-more-child-862?t=3780) Case Studies: Raiding the Pantry and Excessive Screen Time (Ep 2)
- [0:00](https://origin-library.globalcastmd.com/watch/making-the-assessment-management-and-treatment-of-obesity-come-alive-in-your-865?t=0) Introduction and Institute Mission (Ep 3)
- [7:00](https://origin-library.globalcastmd.com/watch/making-the-assessment-management-and-treatment-of-obesity-come-alive-in-your-865?t=420) Algorithm Development and Rationale (Ep 3)
- [15:00](https://origin-library.globalcastmd.com/watch/making-the-assessment-management-and-treatment-of-obesity-come-alive-in-your-865?t=900) Assessment Framework: Behaviors and Weight Classification (Ep 3)
- [23:00](https://origin-library.globalcastmd.com/watch/making-the-assessment-management-and-treatment-of-obesity-come-alive-in-your-865?t=1380) Augmented Assessment for At-Risk Children (Ep 3)
- [32:00](https://origin-library.globalcastmd.com/watch/making-the-assessment-management-and-treatment-of-obesity-come-alive-in-your-865?t=1920) Laboratory Screening Guidelines (Ep 3)
- [38:00](https://origin-library.globalcastmd.com/watch/making-the-assessment-management-and-treatment-of-obesity-come-alive-in-your-865?t=2280) Obesity-Related Comorbidities (Ep 3)
- [42:00](https://origin-library.globalcastmd.com/watch/making-the-assessment-management-and-treatment-of-obesity-come-alive-in-your-865?t=2520) Four-Stage Treatment Framework and Implementation (Ep 3)
- [0:00](https://origin-library.globalcastmd.com/watch/clinical-research-facilitators-barriers-and-preferences-of-parents-of-children-w-13884?t=0) Barriers to Childhood Obesity Research Enrollment (Ep 4)

## Statements
Every statement is attributed, typed, and timestamped; the link is the citation.
- In clinical practice, calculating total weekly structured activity minutes from PE class, recess, and extracurriculars reveals that some kids have as little as 100 minutes per week while others have as much as 500 minutes per week — Jody Dimanta (clinical) [Ep 1 · 10:20](https://origin-library.globalcastmd.com/watch/exercise-journal-club-pediatric-obesity-2017-370?t=620)
- Activity planning is very individual and requires constantly evaluating what works for each family at a particular time (opinion) [Ep 1 · 13:10](https://origin-library.globalcastmd.com/watch/exercise-journal-club-pediatric-obesity-2017-370?t=790)
- In the Choosing Healthy and Active Lifestyles for Kids program, schools can control kids during the school year and most kids eat breakfast and lunch at school, but there is not great control during summer — John (clinical) [Ep 1 · 15:34](https://origin-library.globalcastmd.com/watch/exercise-journal-club-pediatric-obesity-2017-370?t=934)
- In Maine, physical activity is the behavior that isn't changing as much as desired over the last 10 years of tracking — Tory (epidemiological) [Ep 1 · 16:44](https://origin-library.globalcastmd.com/watch/exercise-journal-club-pediatric-obesity-2017-370?t=1004)
- There is a significant correlation between obesity and ADHD, with decreased dopamine activity proposed as a common underlying pathway contributing to both conditions (clinical) [Ep 1 · 22:31](https://origin-library.globalcastmd.com/watch/exercise-journal-club-pediatric-obesity-2017-370?t=1351)
- Stimulants act to increase dopamine activity, and taking a break from stimulant medication puts patients in a position where they are seeking more input, which might be from food or other environmental stimuli (clinical) [Ep 1 · 22:31](https://origin-library.globalcastmd.com/watch/exercise-journal-club-pediatric-obesity-2017-370?t=1351)
- For weight management, the recommendation is to take stimulant medication every day with no breaks, including weekends and summer, because it helps with functioning in every realm of life (opinion) [Ep 1 · 22:31](https://origin-library.globalcastmd.com/watch/exercise-journal-club-pediatric-obesity-2017-370?t=1351)
- Beta blockers and antihistamines are medications known to aggravate obesity — Alan (clinical) [Ep 1 · 23:24](https://origin-library.globalcastmd.com/watch/exercise-journal-club-pediatric-obesity-2017-370?t=1404)
- Some children on ADHD medications struggle to maintain weight and may need medication breaks, particularly when side effects include blood pressure issues or personality changes — John (clinical) [Ep 1 · 23:38](https://origin-library.globalcastmd.com/watch/exercise-journal-club-pediatric-obesity-2017-370?t=1418)
- For children with obesity whose main ADHD manifestation is impulsivity, which can affect eating habits, staying on medication regularly is more likely to be recommended — John (opinion) [Ep 1 · 23:38](https://origin-library.globalcastmd.com/watch/exercise-journal-club-pediatric-obesity-2017-370?t=1418)
- Weight is not a behavior; weight loss is not something a child can go home and do. Providers should focus on healthy habits applicable to all children regardless of size. (guideline) [Ep 2 · 0:00](https://origin-library.globalcastmd.com/watch/taking-the-battle-out-of-getting-kids-to-eat-healthier-and-move-more-child-862?t=0)
- Authoritarian (controlling, strict) parenting may involve hand-feeding long after developmentally appropriate or restricting intake, overriding the child's internal cues. (clinical) [Ep 2 · 0:00](https://origin-library.globalcastmd.com/watch/taking-the-battle-out-of-getting-kids-to-eat-healthier-and-move-more-child-862?t=0)
- Indulgent (permissive) parenting uses food as comfort or reward to control behavior, with the child in control much of the time. (clinical) [Ep 2 · 0:00](https://origin-library.globalcastmd.com/watch/taking-the-battle-out-of-getting-kids-to-eat-healthier-and-move-more-child-862?t=0)
- Uninvolved (neglectful) parenting leaves young children responsible for choosing their own food and deciding how much to eat, with no structure or expectations. (clinical) [Ep 2 · 0:00](https://origin-library.globalcastmd.com/watch/taking-the-battle-out-of-getting-kids-to-eat-healthier-and-move-more-child-862?t=0)
- Authoritative (responsive) parenting sets structure and limits with clear roles, communicates warmly, respects the child's opinions but does not give in to all demands, allowing the child to learn self-regulation. (guideline) [Ep 2 · 0:00](https://origin-library.globalcastmd.com/watch/taking-the-battle-out-of-getting-kids-to-eat-healthier-and-move-more-child-862?t=0)
- When parents take too much control (forcing, pressuring, restricting), they override the child's internal hunger and fullness cues or desire to be active. (clinical) [Ep 2 · 9:58](https://origin-library.globalcastmd.com/watch/taking-the-battle-out-of-getting-kids-to-eat-healthier-and-move-more-child-862?t=598)
- When parents give the child too much control (indulging, bribing), it teaches the child they can get their favorite food by whining or crying. (clinical) [Ep 2 · 9:58](https://origin-library.globalcastmd.com/watch/taking-the-battle-out-of-getting-kids-to-eat-healthier-and-move-more-child-862?t=598)
- Breastfeeding is the first introduction to the family table; breastfed babies get used to different flavor profiles from the mother's diet, which may prevent picky eating tendencies later. (clinical) [Ep 2 · 20:40](https://origin-library.globalcastmd.com/watch/taking-the-battle-out-of-getting-kids-to-eat-healthier-and-move-more-child-862?t=1240)
- A baby's crying can mean many things (wet diaper, discomfort), not just hunger. Parents should learn to read cues rather than automatically feeding in response to crying. (clinical) [Ep 2 · 20:40](https://origin-library.globalcastmd.com/watch/taking-the-battle-out-of-getting-kids-to-eat-healthier-and-move-more-child-862?t=1240)
- When a toddler throws food off the highchair tray, that is a cue that mealtime is over. If they continue eating food on the tray, the parent should let them continue. (clinical) [Ep 2 · 20:40](https://origin-library.globalcastmd.com/watch/taking-the-battle-out-of-getting-kids-to-eat-healthier-and-move-more-child-862?t=1240)
- It is acceptable for a preschooler to skip a meal. The parent should let them know the next eating opportunity will be the next scheduled meal or snack, with only water available in between. (guideline) [Ep 2 · 20:40](https://origin-library.globalcastmd.com/watch/taking-the-battle-out-of-getting-kids-to-eat-healthier-and-move-more-child-862?t=1240)
- The 60 minutes of daily physical activity can be broken up throughout the day (e.g., 20 minutes before school, 20 minutes after school, 20 minutes after dinner). (guideline) [Ep 2 · 28:22](https://origin-library.globalcastmd.com/watch/taking-the-battle-out-of-getting-kids-to-eat-healthier-and-move-more-child-862?t=1702)
- Moderate to vigorous activity means the body is working: increased heart rate, sweating, muscle fatigue, and shortness of breath are normal cues that should be taught to children as positive signs. (clinical) [Ep 2 · 28:22](https://origin-library.globalcastmd.com/watch/taking-the-battle-out-of-getting-kids-to-eat-healthier-and-move-more-child-862?t=1702)
- When parents praise a child for finishing all their food, it sets the child up to want to finish all meals to get praise again, overriding their hunger and fullness cues. (clinical) [Ep 2 · 39:26](https://origin-library.globalcastmd.com/watch/taking-the-battle-out-of-getting-kids-to-eat-healthier-and-move-more-child-862?t=2366)
- Using food as a reward for good behavior teaches the child that food is contingent on behavior rather than an expectation. Good behavior should be an expectation with or without rewards. (guideline) [Ep 2 · 39:26](https://origin-library.globalcastmd.com/watch/taking-the-battle-out-of-getting-kids-to-eat-healthier-and-move-more-child-862?t=2366)
- When a parent makes vegetable intake contingent on getting dessert (e.g., 'eat your broccoli to get a brownie'), it teaches the child that vegetables are yucky and dessert is the reward. (clinical) [Ep 2 · 39:26](https://origin-library.globalcastmd.com/watch/taking-the-battle-out-of-getting-kids-to-eat-healthier-and-move-more-child-862?t=2366)
- If dessert is on the menu, everyone in the family should get one serving regardless of what else they ate. The parent decides which days dessert is offered, not whether the child 'earned' it. (guideline) [Ep 2 · 39:26](https://origin-library.globalcastmd.com/watch/taking-the-battle-out-of-getting-kids-to-eat-healthier-and-move-more-child-862?t=2366)
- Productive screen time (homework, school work) does not count toward the 2-hour daily screen time limit. The limit applies to unproductive screen time (TV, video games). (guideline) [Ep 2 · 47:55](https://origin-library.globalcastmd.com/watch/taking-the-battle-out-of-getting-kids-to-eat-healthier-and-move-more-child-862?t=2875)
- Taking away physical activity as punishment is counterproductive. A misbehaving child may need physical activity to release pent-up energy and refocus their behavior. (clinical) [Ep 2 · 47:55](https://origin-library.globalcastmd.com/watch/taking-the-battle-out-of-getting-kids-to-eat-healthier-and-move-more-child-862?t=2875)
- Using physical activity as punishment (e.g., 'run 3 laps around the house') teaches the child to associate physical activity with something to avoid, undermining lifelong motivation. (clinical) [Ep 2 · 47:55](https://origin-library.globalcastmd.com/watch/taking-the-battle-out-of-getting-kids-to-eat-healthier-and-move-more-child-862?t=2875)
- A 'brain break' before homework—getting the child up and moving for a few minutes to raise heart rate—helps refocus the brain and makes homework more efficient. (clinical) [Ep 2 · 47:55](https://origin-library.globalcastmd.com/watch/taking-the-battle-out-of-getting-kids-to-eat-healthier-and-move-more-child-862?t=2875)
- There are not enough chips to fill a child up. Snacks lacking protein will not satisfy hunger, leading to grazing and overeating at dinner. (clinical) [Ep 2 · 63:00](https://origin-library.globalcastmd.com/watch/taking-the-battle-out-of-getting-kids-to-eat-healthier-and-move-more-child-862?t=3780)
- Protein is a crucial component in snacks to help keep a child feeling full until the next meal. (clinical) [Ep 2 · 63:00](https://origin-library.globalcastmd.com/watch/taking-the-battle-out-of-getting-kids-to-eat-healthier-and-move-more-child-862?t=3780)
- Children should not go more than 4 hours without eating. Skipping meals or going too long without eating impairs the child's ability to gauge hunger and fullness cues at the next meal. (guideline) [Ep 2 · 63:00](https://origin-library.globalcastmd.com/watch/taking-the-battle-out-of-getting-kids-to-eat-healthier-and-move-more-child-862?t=3780)
- Over the last few years, there has been increased understanding and research that children with overweight and obesity may be sick, and oftentimes those children are not being appropriately screened for comorbidities. — Corey (epidemiological) [Ep 3 · 7:00](https://origin-library.globalcastmd.com/watch/making-the-assessment-management-and-treatment-of-obesity-come-alive-in-your-865?t=420)
- The algorithm relies on existing guidelines: 2007 Expert Committee recommendations, US Department of Health and Human Services cardiovascular guidelines, and American Diabetes Association guidelines. — Corey (guideline) [Ep 3 · 9:00](https://origin-library.globalcastmd.com/watch/making-the-assessment-management-and-treatment-of-obesity-come-alive-in-your-865?t=540)
- The algorithm is not a protocol but a suggested course of action that provides guidance to be used with clinical judgment. — Corey (guideline) [Ep 3 · 11:00](https://origin-library.globalcastmd.com/watch/making-the-assessment-management-and-treatment-of-obesity-come-alive-in-your-865?t=660)
- The algorithm applies to patients 2 years and older and does not address the birth to 2-year age group. — Corey (guideline) [Ep 3 · 12:00](https://origin-library.globalcastmd.com/watch/making-the-assessment-management-and-treatment-of-obesity-come-alive-in-your-865?t=720)
- For all patients irrespective of weight, screening for genetic dyslipidemia should include obtaining a non-fasting lipid profile for children between ages 9-11 and again between 18-21, per cardiovascular guidelines from about 3 years ago. — Corey (guideline) [Ep 3 · 17:00](https://origin-library.globalcastmd.com/watch/making-the-assessment-management-and-treatment-of-obesity-come-alive-in-your-865?t=1020)
- Positive symptoms in the review of systems that could indicate risk for comorbidities include snoring, sleep disturbances, abdominal pain, menstrual irregularities, hip/knee/leg pain, polyuria, polydipsia, and depression. — Corey (clinical) [Ep 3 · 21:00](https://origin-library.globalcastmd.com/watch/making-the-assessment-management-and-treatment-of-obesity-come-alive-in-your-865?t=1260)
- Physical exam findings that may indicate comorbidities include pre-hypertension or hypertension (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 3 · 23:00](https://origin-library.globalcastmd.com/watch/making-the-assessment-management-and-treatment-of-obesity-come-alive-in-your-865?t=1380)
- Family history risk factors in first and second degree relatives include obesity, type 2 diabetes, hypertension, lipid level abnormalities, and heart disease. — Corey (clinical) [Ep 3 · 26:00](https://origin-library.globalcastmd.com/watch/making-the-assessment-management-and-treatment-of-obesity-come-alive-in-your-865?t=1560)
- Patients in the overweight category (BMI 85th-94th percentile) with strong family history, positive review of systems, or positive physical exam should receive further screening for comorbidities, similar to patients in the obese category. — Corey (guideline) [Ep 3 · 28:00](https://origin-library.globalcastmd.com/watch/making-the-assessment-management-and-treatment-of-obesity-come-alive-in-your-865?t=1680)
- Some providers obtain non-fasting labs for patient convenience, particularly in rural areas where patients travel long distances and are unlikely to return for fasting labs. — Corey (clinical) [Ep 3 · 32:00](https://origin-library.globalcastmd.com/watch/making-the-assessment-management-and-treatment-of-obesity-come-alive-in-your-865?t=1920)
- Some subspecialty clinics screen for vitamin D and insulin resistance by obtaining vitamin D and fasting insulin levels, but the clinical utility and cost-effectiveness of such tests is yet to be determined, and the costs are very high. — Corey (opinion) [Ep 3 · 34:00](https://origin-library.globalcastmd.com/watch/making-the-assessment-management-and-treatment-of-obesity-come-alive-in-your-865?t=2040)
- There are no current guidelines on when to start laboratory testing for patients with obesity, but based on patient health risks, some experts may start screening patients as early as 2 years of age. — Corey (guideline) [Ep 3 · 35:00](https://origin-library.globalcastmd.com/watch/making-the-assessment-management-and-treatment-of-obesity-come-alive-in-your-865?t=2100)
- Constipation is a very common comorbidity in children with obesity that is easily treated, and treating it helps patients feel better, eat more, and be more physically active. — Corey (clinical) [Ep 3 · 37:00](https://origin-library.globalcastmd.com/watch/making-the-assessment-management-and-treatment-of-obesity-come-alive-in-your-865?t=2220)
- Not every patient is ready for treatment, and when patients or parents are not ready, the appropriate response is to say 'that's OK, when you're ready, I'm ready' rather than using fear tactics. — Corey (opinion) [Ep 3 · 41:00](https://origin-library.globalcastmd.com/watch/making-the-assessment-management-and-treatment-of-obesity-come-alive-in-your-865?t=2460)
- There are no quick fixes for obesity treatment; even patients eligible for surgical treatment require many months of behavior modification and treatment before surgery. — Corey (clinical) [Ep 3 · 42:00](https://origin-library.globalcastmd.com/watch/making-the-assessment-management-and-treatment-of-obesity-come-alive-in-your-865?t=2520)
- Small behavior changes can have a profound effect on health and are usually much more sustainable than large changes. — Corey (opinion) [Ep 3 · 44:00](https://origin-library.globalcastmd.com/watch/making-the-assessment-management-and-treatment-of-obesity-come-alive-in-your-865?t=2640)
- In pediatrics, by and large up until growth plates fuse, children are going to get taller, which is advantageous for weight management. — Corey (clinical) [Ep 3 · 46:00](https://origin-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 stage and advance through stages based on response to treatment, age, BMI, health risks, and most importantly the motivation of the patient and family. — Corey (guideline) [Ep 3 · 48:00](https://origin-library.globalcastmd.com/watch/making-the-assessment-management-and-treatment-of-obesity-come-alive-in-your-865?t=2880)
- An empathetic, empowering counseling style such as motivational interviewing should be employed to empower patients and families in behavior change, with no fear tactics. — Corey (guideline) [Ep 3 · 46:57](https://origin-library.globalcastmd.com/watch/making-the-assessment-management-and-treatment-of-obesity-come-alive-in-your-865?t=2817)
- Stage 1 (Prevention Plus) consists of planned follow-up themed visits of 15-20 minutes in primary care, focusing on behaviors that resonate with the patient, family, and provider, with the patient's preferences coming first. — Corey (guideline) [Ep 3 · 46:57](https://origin-library.globalcastmd.com/watch/making-the-assessment-management-and-treatment-of-obesity-come-alive-in-your-865?t=2817)
- The goals for Stage 1 are positive behavior change irregardless of change in BMI, and weight maintenance or decrease in BMI velocity. — Corey (guideline) [Ep 3 · 46:57](https://origin-library.globalcastmd.com/watch/making-the-assessment-management-and-treatment-of-obesity-come-alive-in-your-865?t=2817)
- Children ages 2-5 with obesity should not lose more than 1 pound per month, and older children and adolescents with obesity should not lose more than an average of 2 pounds per week. — Corey (guideline) [Ep 3 · 46:57](https://origin-library.globalcastmd.com/watch/making-the-assessment-management-and-treatment-of-obesity-come-alive-in-your-865?t=2817)
- Many experts recommend monthly follow-up visits for Stage 1, though follow-up can be tailored to patient and family motivation and can include text, email, or Facebook communication. — Corey (guideline) [Ep 3 · 46:57](https://origin-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 does not improve, consider advancing to Stage 2. — Corey (guideline) [Ep 3 · 46:57](https://origin-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 the same intervention as Stage 1 but includes more intensive support and structure to achieve healthy behaviors, with follow-up every 2-4 weeks. — Corey (guideline) [Ep 3 · 46:57](https://origin-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 often done by a pediatric weight management clinic with a multidisciplinary team including social workers and dietitians, with structured behavior modification including food and activity monitoring. — Corey (guideline) [Ep 3 · 46:57](https://origin-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 greater than the 95th percentile with significant comorbidities, happens in a pediatric weight management center with providers with expertise in treating childhood obesity, and includes very intensive diet and activity counseling with consideration of medications and age-appropriate surgery. — Corey (guideline) [Ep 3 · 46:57](https://origin-library.globalcastmd.com/watch/making-the-assessment-management-and-treatment-of-obesity-come-alive-in-your-865?t=2817)
- The goal for Stage 4 is a decrease in BMI because these children are sick and need to get their BMI down, though behavior change is still initially important. — Corey (guideline) [Ep 3 · 46:57](https://origin-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.
- Researchers surveyed more than 100 parents of children with overweight or obesity to understand what influences their decision to participate in research — Lizzie Lee summarizing a resource [Ep 4 · 0:07](https://origin-library.globalcastmd.com/watch/clinical-research-facilitators-barriers-and-preferences-of-parents-of-children-w-13884?t=7)
- Parents reported more reasons to participate in childhood obesity research than reasons not to participate — Lizzie Lee summarizing a resource [Ep 4 · 0:15](https://origin-library.globalcastmd.com/watch/clinical-research-facilitators-barriers-and-preferences-of-parents-of-children-w-13884?t=15)
- Mistrust, time demands, and social pressure are barriers that make it harder for parents to participate in childhood obesity research — Lizzie Lee summarizing a resource [Ep 4 · 0:15](https://origin-library.globalcastmd.com/watch/clinical-research-facilitators-barriers-and-preferences-of-parents-of-children-w-13884?t=15)
- Research perceptions varied by family characteristics — Lizzie Lee summarizing a resource [Ep 4 · 0:26](https://origin-library.globalcastmd.com/watch/clinical-research-facilitators-barriers-and-preferences-of-parents-of-children-w-13884?t=26)
- To improve childhood obesity research, studies need to be easier to join, reduce participation burden, and build trust with families from the beginning — Lizzie Lee summarizing a resource [Ep 4 · 0:30](https://origin-library.globalcastmd.com/watch/clinical-research-facilitators-barriers-and-preferences-of-parents-of-children-w-13884?t=30)
- The study sample consisted of 13,006 children from 846 schools after excluding children with missing covariates and children from year-round schools — Jody Dimanta summarizing the discussion [Ep 1 · 3:20](https://origin-library.globalcastmd.com/watch/exercise-journal-club-pediatric-obesity-2017-370?t=200)
- Children's height and weights were measured each fall and spring for a total of 6 occasions, with fall measurements taken 5-7 weeks after the first day of school and spring measurements taken 8 weeks before the last day of school — Jody Dimanta summarizing the discussion [Ep 1 · 3:50](https://origin-library.globalcastmd.com/watch/exercise-journal-club-pediatric-obesity-2017-370?t=230)
- Obesity prevalence increased from 8.9% to 11.5% and overweight prevalence increased from 23.3% to 28.7% over the study period — Jody Dimanta summarizing the discussion [Ep 1 · 5:10](https://origin-library.globalcastmd.com/watch/exercise-journal-club-pediatric-obesity-2017-370?t=310)
- All increases in obesity and overweight prevalences occurred during the two summer vacations with no increases during any of the three school years — Jody Dimanta summarizing the discussion [Ep 1 · 5:40](https://origin-library.globalcastmd.com/watch/exercise-journal-club-pediatric-obesity-2017-370?t=340)
- During summer 1 and summer 2, both overweight and obesity prevalences increased by approximately 1% point per month — Jody Dimanta summarizing the discussion [Ep 1 · 6:10](https://origin-library.globalcastmd.com/watch/exercise-journal-club-pediatric-obesity-2017-370?t=370)
- Over the average summer vacation of 2.6 to 2.7 months, there was a 2-3% rise in overweight and obesity points — Jody Dimanta summarizing the discussion [Ep 1 · 6:40](https://origin-library.globalcastmd.com/watch/exercise-journal-club-pediatric-obesity-2017-370?t=400)
- During the school year, there was a decrease in obesity prevalence during kindergarten and second grade years — Jody Dimanta summarizing the discussion [Ep 1 · 7:10](https://origin-library.globalcastmd.com/watch/exercise-journal-club-pediatric-obesity-2017-370?t=430)
- The standard deviation of BMI growth is approximately 3 times greater during the 2 summers than during the 3 school years — Jody Dimanta summarizing the discussion [Ep 1 · 7:40](https://origin-library.globalcastmd.com/watch/exercise-journal-club-pediatric-obesity-2017-370?t=460)
- Children tend to sleep less and watch more screen time during summer — Jody Dimanta summarizing the discussion [Ep 1 · 8:40](https://origin-library.globalcastmd.com/watch/exercise-journal-club-pediatric-obesity-2017-370?t=520)
- School-based interventions that tried to carry things over into the summer for families did not show any positive effect — Jody Dimanta summarizing the discussion [Ep 1 · 9:20](https://origin-library.globalcastmd.com/watch/exercise-journal-club-pediatric-obesity-2017-370?t=560)
- In Minnesota, the requirement for gym class is 1 year out of 4 years of high school, with only half of that year being gym and the other half being health — Em Gootee summarizing the discussion [Ep 1 · 18:00](https://origin-library.globalcastmd.com/watch/exercise-journal-club-pediatric-obesity-2017-370?t=1080)
- Research shows it can take 10, 15, or more exposures for a child to accept a previously refused food. — The host summarizing a resource [Ep 2 · 9:58](https://origin-library.globalcastmd.com/watch/taking-the-battle-out-of-getting-kids-to-eat-healthier-and-move-more-child-862?t=598)
- The American Academy of Pediatrics recommends no screen time for infants, and for children 2 years and older, no more than 2 hours of screen time daily. — The host summarizing a resource [Ep 2 · 28:22](https://origin-library.globalcastmd.com/watch/taking-the-battle-out-of-getting-kids-to-eat-healthier-and-move-more-child-862?t=1702)
- Toddlers need at least 30 minutes of structured physical activity daily and at least 60 minutes (up to several hours) of unstructured physical activity. They should not be sedentary for more than 60 minutes at a time except when sleeping. — The host summarizing a resource [Ep 2 · 28:22](https://origin-library.globalcastmd.com/watch/taking-the-battle-out-of-getting-kids-to-eat-healthier-and-move-more-child-862?t=1702)
- School-age children need to be active 60 minutes a day, with most activity being aerobic at moderate to vigorous intensity, plus muscle and bone strengthening activities. — The host summarizing a resource [Ep 2 · 28:22](https://origin-library.globalcastmd.com/watch/taking-the-battle-out-of-getting-kids-to-eat-healthier-and-move-more-child-862?t=1702)
- The 2007 Expert Committee recommendations state that for patients with BMI over the 85th percentile, providers should be thinking differently about them and having a pausing moment because these children could be sick. — Corey summarizing the discussion [Ep 3 · 19:00](https://origin-library.globalcastmd.com/watch/making-the-assessment-management-and-treatment-of-obesity-come-alive-in-your-865?t=1140)
- The 2007 Expert Committee recommendations state that a fasting glucose, fasting lipid profile, ALT, and AST should be obtained in patients in the overweight category with risk factors and in the obese category. — Corey summarizing the discussion [Ep 3 · 30:00](https://origin-library.globalcastmd.com/watch/making-the-assessment-management-and-treatment-of-obesity-come-alive-in-your-865?t=1800)
- Guidelines from the ADA and Endocrine Society recommend hemoglobin A1c, fasting glucose, or oral glucose tolerance test to screen for diabetes or pre-diabetes. — Corey summarizing the discussion [Ep 3 · 31:00](https://origin-library.globalcastmd.com/watch/making-the-assessment-management-and-treatment-of-obesity-come-alive-in-your-865?t=1860)
- The Children's Hospital Association consensus statements on comorbidities may help keep management of children with obesity in their medical home and provide guidance to sites that may not have specialists available. — Corey summarizing the discussion [Ep 3 · 39:00](https://origin-library.globalcastmd.com/watch/making-the-assessment-management-and-treatment-of-obesity-come-alive-in-your-865?t=2340)
- Research by Ken Resnicow and his team at University of Michigan shows that motivational interviewing works for behavior change and for obesity management and treatment. — Corey summarizing the discussion [Ep 3 · 43:00](https://origin-library.globalcastmd.com/watch/making-the-assessment-management-and-treatment-of-obesity-come-alive-in-your-865?t=2580)

## Changelog
- Oct 1: 1 item added automatically
- Sep 16: 3 items added automatically

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