Management approaches for pediatric obesity.

Childhood obesity is a worldwide problem that has reached epidemic proportions, resulting in an increased prevalence of premature obesity-related morbidities, and, thus, probable increased health-care costs to treat children. The development of viable approaches to manage this epidemic is crucial. Most experts in the field of childhood obesity agree that the prevention of obesity in children should be the first line of management. Pediatricians must be adept at recognizing children at risk of obesity, calculating and plotting the BMI at all visits, using a change in the BMI to identify excessive weight gain, and monitoring for comorbidities associated with obesity. If obesity is present, the cornerstone of treatment is modification of dietary and exercise habits. Practice-based counseling and community-based programs that support and encourage lifestyle modifications have yielded promising short-term results. Children with severe comorbidities who are unable to achieve lifestyle modifications can be considered for either pharmacologic therapy or surgery, but these options should be considered as a last resort. Early intervention and prevention strategies are the most cost-effective methods of dealing with this issue.