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  The Health Care Sector and Providers can play a role in preventing Chlidren  
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.
Health-Care Professionals
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
The Health-Care Sector and Providers Can Play a Role in
Preventing Childhood Obesity
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.
Drawn from Preventing Childhood Obesity: Health in the Balance, 2005 • Institute of Medicine • www.iom.edu
Training Programs and Professional
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.
Insurance Providers, Health Plans, and Quality
Improvement and Accrediting 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
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.
Drawn from Preventing Childhood Obesity: Health in the Balance, 2005 • Institute of Medicine • www.iom.edu
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