Clinical perspectives on pediatric weight-management programs: A nationwide look at models of care

Obesity is a common, complex, and often persistent chronic disease associated with serious health and social consequences. In the United States, recent data indicates that almost 20% of children and adolescents have obesity. Management of pediatric obesity involves multidisciplinary teams, including pediatricians, pediatric specialists, dietitians, behavioral health specialists, and exercise professionals, who deliver intensive health behavior and lifestyle treatment. Prior survey data from Pediatric Endocrine Society (PES) members indicate variability in practice patterns. There is an urgent need to assess current practices across groups and use these data to establish a standard of care across institutions.

This is a cross-sectional survey of 38 providers who treat pediatric obesity. We report descriptive statistics (mean/median/IQR) only.

Of 168 potential respondents, 38 completed the survey. 61% of the clinics are run within the Pediatric Endocrine division. All clinics offer pharmacotherapy, while only some offer bariatric surgery treatment. There is a wide divergence in the structure, staffing, visit frequency, intake process, and operational workflow between programs. All programs are staffed with a physician or APP, 97% with dieticians, 60% with psychologists or behavioral health therapists, and 39% with bariatric surgeons. Ideal and actual follow up times were mismatched, with programs wanting to see patients for follow up more often than they were able to.

The survey provides a detailed snapshot of current practices within pediatric weight management programs, highlighting the strengths and the substantial variability that characterize the field. While many clinics share core elements, there remains a divergence in others. These differences reflect the diverse environments in which programs operate and underscore the benefit of standardized models for delivering pediatric obesity care. This survey is an important foundation, but broader national efforts are essential to guide standardization, inform policy, and support the development of high-quality, accessible pediatric obesity care.