Preventing and managing pediatric obesity. Recommendations for family physicians.

OBJECTIVE To review the evidence on prevention and management of childhood obesity and to offer suggestions for family physicians.

QUALITY OF EVIDENCE Articles were obtained from a PubMed search. Most studies on pediatric obesity provide level II evidence. There are some level I studies on management.

MAIN MESSAGE Pediatric obesity is underdiagnosed and undertreated. Prevention should be initiated as early as pregnancy. Prevention and treatment approaches should include patient and family interventions focusing on nutrition, physical activity, reduced television viewing, and behaviour modification. The effectiveness of such interventions by primary care physicians has not been totally demonstrated, but incorporating them into clinical practice routines is likely to be beneficial.

CONCLUSION Family physicians have a role in promoting preventive measures and identifying and treating obesity-related comorbidity. Pediatric obesity is not an individual child's problem, but a problem that involves the whole family and the community. Recommending a healthy diet and increased physical activity and counseling families on behaviour change is the best approach to preventing and managing childhood obesity.