Handbook of Pediatric Obesity: Clinical Management PDF

Preface

We are very pleased and honored to edit the Handbook of Pediatric Obesity: Clinical Management . We accept this responsibility with much enthusiasm. We believe that this text will provide a scientifically sound, clinically relevant survey of the available approaches for the treatment of pediatric obesity to pediatric health care and research professionals. In addition, a portion of proceeds of this book will be donated to the Pediatric Obesity Interest Group of the North American Association for the Study of the Obesity (NAASO): The Obesity Society and, thus, will be available to us as a community of researchers and health care providers for the purposes of educational seminars, research opportunities, and future pediatric obesity prevention and treatment projects.

Over the last two decades, we have been privileged to participate in clinical research studies that provided continued opportunities to review the scientific evidence related to pediatric obesity. This experience and knowledge confirmed the complexity of pediatric obesity. It is clear from the scientific literature that the direct causes of pediatric obesity remain undiscovered and that standards for treatment, although desperately needed, are nonexistent.

During this same two decades, we also had the opportunity to provide treatment to thousands of overweight children and their families. We observed over this time that the severity of obesity in these patients has increased and, even more disturbing, that these children have become more and more resistant to traditional treatment approaches. Today's overweight children are very difficult to treat. The sentiment of most clinicians and researchers has become negative and self-defeating. However, rather than assume the position that the only way to curb the current pediatric obesity epidemic is to ignore this generation and focus on prevention in the next, we, along with the contributing authors, accepted the task of compiling the available management, medical, nutrition, psychological, and physical activity facts, models, theories, interventions, and evaluation techniques. Our mission was to provide the most clinically appropriate, scientifically supported source of information to the pediatric health care and research professional. It is our hope we have accomplished our mission. We feel we have produced a comprehensive, state-of-the-art, and easyto- use reference that can be used by pediatric health care and research professionals to develop programs and provide the best possible care to overweight children in clinical settings.

The introduction provides an overview of the problem of pediatric obesity and includes global options for solutions. Section 1 details pediatric obesity clinical management strategies, challenges, business plans, and evaluation methods. Section 2 discusses the medical aspects of treatment including complications and comorbidities of pediatric obesity and the physician's role in treatment. In Section 3, psychosocial and physical considerations associated with pediatric obesity are discussed, as well as how each affects the treatment process. Section 4 offers the reader a comprehensive survey of pediatric obesity medical, nutrition, behavioral, and exercise evaluation methods and techniques. Options for nutrition intervention in overweight youth are detailed in Section 5, behavioral counseling in Section 6, and methods to increase physical activity and provide exercise training in Section 7. Section 8 discusses Internet-based approaches used in pediatric clinical settings, Section 9, the role of pharmacology as it relates to pediatric obesity treatment, and Section 10, an overview of surgery options for significantly obese adolescents. The final section presents specific techniques and methods for conducting interdisciplinary, interactive group instruction for overweight children and their families. A comprehensive appendix follows Chapter 20 and is divided into three sections: clinical management forms, testing and measurement protocols, and sample intervention materials. Throughout the text, individual chapters discuss management strategies, methods, and techniques that refer to specific forms, protocols, handouts, and sources located in the Appendix. These are practical and applied techniques, information, and tools that may be used, as needed, to develop, modify, implement, and evaluate weight-management programs for children and adolescents in clinical and research settings.

As pediatric health care and research professionals, you have an important responsibility to overweight children and adolescents. Your approach, interaction, and follow-up procedures have a tremendous effect on the physical and emotional health of your patients. When families come to you for help with overweight problems, your initial words, actions, and demeanor will set the stage for weight-management success or failure. We strongly believe that the success or failure of your patients to achieve a healthy weight is a shared responsibility. We encourage you to accept this responsibility and this challenge with an open heart and a positive attitude. We hope you will dedicate the necessary time and energy to providing the most appropriate care to your overweight patients. Your reward will be an unbelievable feeling of accomplishment and self-satisfaction.

Throughout this text we've provided you with the necessary information and tools to do your job well. This knowledge will enable you to become proficient in matching or tailoring the available treatment plans to the medical, physical, and emotional needs of your patient. There are many options, and it is clear that there is no single solution for every overweight child. However, for each child, an individualized plan can be developed that will best manage obesity and enhance his or her emotional and physical health.