The Health Care Sector and Providers can play a role in preventing Chlidren Obesity

Health-care professionals have frequent opportunities

to encourage children, youth, and their

parents to engage in healthful lifestyles.

Unfortunately, treatment of obesity per se is rarely considered

a reimbursable interaction between patient and

doctor, and our current health-care system is not yet

focused on preventive measures for childhood obesity.

But the health-care delivery system can still have a significant

impact on this issue. It is now up to health-care

professionals and their professional organizations, as

well as health insurers and quality improvement and

accrediting agencies, to make obesity prevention a part

of routine preventive health care.

As health-care advisors both to children and their parents,

physicians, nurses, dietitians, and other clinicians

have access and the authority to influence families'

awareness of obesity as a health concern and offer them

guidance on pursuing healthful dietary habits and regular

physical activity.

To achieve this goal, health-care providers should routinely

measure their young patients' height and weight

and calculate their body mass index (BMI) during every

health supervision visit. By doing so, clinicians indicate

to families that BMI is just as important as routine

immunizations or screening tests in protecting children's

health. Despite the availability of standardized

BMI charts for children, the majority of caregivers currently

rely on clinical impression and weight-for-age or

weight-for-height measures rather than BMI to assess

risk of obesity.

After determining the child's weight status, health-care

professionals have a responsibility to carefully communicate

the results to parents and, in an age-appropriate

manner, to the children themselves; provide the information

that the families need to make informed decision

about physical activity and nutrition; and explain

the risks associated with childhood overweight and

obesity. Behaviors that can be targeted include those

most closely associated with improved nutrition and

increased physical activity: increased breastfeeding,

limited consumption of sweetened beverages, reduced

television viewing or other screen time, and a greater

amount of outdoor play. Careful attention should be

paid to minimizing the stigmatization of obesity.

Pediatricians, family physicians, nurses, dietitians, and

other clinicians also should serve as role models for

healthful eating and regular physical activity. They

should take leadership roles in advocating for

childhood obesity prevention in local schools and

communities.

FACT SHEET • SEPTEMBER 2004 INSTITUTE OF MEDICINE

Pediatricians, family physicians, nurses, and

other clinicians should engage in the prevention

of childhood obesity. Health-care professionals

should routinely track BMI, offer relevant evidence-

based counseling and guidance, serve as

role models, and provide leadership in their communities

for obesity prevention efforts.

Health care professional organizations, insurers,

and accrediting groups should support individual

and population-based obesity prevention efforts.

Professional organizations should disseminate

evidence-based clinical guidance and establish

programs on childhood obesity prevention.

Training programs and certifying entities should

require obesity prevention knowledge and skills in

their curricula and examinations.

Insurers and accrediting organizations should

include screening and obesity preventive services

in routine clinical practice and quality assessment

measures and should provide incentives for main -

taining a healthy body weight.

KEY FACTS

Health-care professionals' training programs have

traditionally provided their students with limited education

in nutrition and physical activity or how to counsel

patients on these topics. To ensure that health

professionals are sufficiently prepared to discuss obesi -

ty risks and prevention with their patients, health professional

schools and other training programs and

agencies that certify health-care providers should

require knowledge and skills related to obesity preven -

tion in their curricula and examinations. These skills

might include how to calculate and interpret BMI levels

for children and knowledge about proper nutrition and

physical activity levels to prevent childhood obesity.

Furthermore, health professional organizations should

also create and disseminate evidence-based clinical

guidelines and other educational materials on childhood

obesity prevention. They should advocate for

childhood obesity prevention initiatives and coordinate

their efforts among professional organizations.

Until recently, efforts had focused largely on the treat

ment of obesity rather than prevention. But increasing

awareness of the rising economic and social costs of

obesity provides incentives to insurers and health plans

to encourage healthful lifestyles.

Insurers and health plans should develop innovative

strategies (such as incentives or discounts) to encourage

individuals and families to maintain healthy body

weights and engage in routine physical activity. Obesity

prevention should become a routine part of clinical

care.

The organizations that oversee quality improvements in

health care and that accredit health-care providers

should ensure that obesity screening and prevention

services are included in routine clinical practice and in

measurements of health-care quality.