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Rethinking obesity counseling: having the French Fry Discussion
Jonathan Bonnet1, Aaron George1, Pippa Evans2
1Department of Community and Family Medicine, Duke University Health System, P.O. Box 104425, Durham, NC 27710, USA.
Insights
Pediatricians face barriers to addressing childhood obesity. Many PCPs (primary care providers) delay discussing fast food habits until a child is two years old, missing crucial early intervention opportunities.
Area of Science:
- Pediatrics
- Family Medicine
- Public Health
Background:
- Childhood obesity requires early intervention, yet current recommendations lack specificity for pediatric populations.
- Family medicine primary care providers (PCPs) play a key role in obesity prevention and treatment.
- Understanding PCPs' perceived barriers and practices is crucial for developing targeted strategies.
Purpose of the Study:
- To examine perceived barriers encountered by PCPs in preventing and treating pediatric obesity.
- To assess the practice behaviors of PCPs regarding obesity-related counseling during well-child visits.
Main Methods:
- A written survey was administered to PCPs across eleven family medicine clinics.
- The survey focused on perceived barriers and current practices related to childhood obesity at well-child visits.
Main Results:
- The primary barriers identified by PCPs were insufficient family exercise (93%) and frequent fast-food consumption (86%).
- Most PCPs do not discuss fast food before the 12-month well-child visit.
- A majority of PCPs (68%) first discuss fast food at the two-year well-child visit.
Conclusions:
- There is no established consensus on when PCPs should initiate discussions about fast food during early well-child visits.
- Dietary habits shift significantly towards fast foods between the one- and two-year well-child visits.
- A "French Fry Discussion" at every 12-month well-child visit is recommended for timely intervention.
Unlabelled:
Childhood obesity is a complex problem that warrants early intervention. General recommendations for obesity prevention and nutrition counseling exist. However, these are notably imprecise with regard to early and targeted interventions to prevent and treat obesity in pediatric populations. This study examines family medicine primary care providers' (PCPs) perceived barriers for preventing and treating pediatric obesity and their related practice behavior during well-child visits.
Methods:
A written survey addressing perceived barriers and current practices addressing obesity at well-child visits were administered to PCPs at eleven family medicine clinics in the Duke University Health System.
Results:
The most common perceived barriers identified by PCPs to prevention or treatment of obesity in children were families not getting enough exercise (93%) and families too often having fast food meals (86%). Most PCPs do not discuss fast foods at or prior to the twelve-month well-child visit. The two-year visit is the first well-child visit at which a majority of PCPs (68%) discuss fast food.
Conclusion:
No clear consensus exists as to when PCPs should discuss fast food in early well-child checks. Previous research has shown a profound shift in children's dietary habits toward fast foods, such as French fries, that occurs between the one- and two-year well-child checks. Consideration should be given to having a "French Fry Discussion" at every twelve-month well-child care visit.
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