Multidisciplinary treatment of pediatric obesity: nutrition evaluation and management

Assessment and treatment methods for pediatric obesity are rapidly evolving. Thought to be caused by an imbalance of caloric intake and expenditure, obesity requires a comprehensive evaluation of patient, familial, environmental, genetic, and cultural characteristics so clinicians can design successful interventions. Quantitative nutrition assessment of caloric intake is difficult and time consuming and should be used only in isolated settings, such as in the research setting, or if initial approaches to management have been unsuccessful. As an alternative, providers should identify dietary patterns or behaviors that have been linked to obesity and are promising targets for change. Clinicians should tailor interventions by considering patient and family motivation and readiness to change. Current guidelines recommend stepwise increases in treatment plans, and multidisciplinary treatment teams are recommended for patients who require intense intervention. Providers involved at the multidisciplinary level must incorporate their area of expertise into that of the team to develop a comprehensive management plan. This article reviews current recommendations for the evaluation and treatment of pediatric obesity with a focus on nutrition evaluation as part of a multidisciplinary team.