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This version published online on September 9, 2008
Journal of Clinical Endocrinology & Metabolism , doi:10.1210/jc.2007-2458
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Submitted on November 5, 2007
Accepted on August 29, 2008

Prevention and Treatment of Pediatric Obesity: An Endocrine Society Clinical Practice Guideline Based on Expert Opinion

Gilbert P. August, Sonia Caprio, Ilene Fennoy, Michael Freemark, Francine R. Kaufman, Robert H. Lustig, Janet H. Silverstein, Phyllis W. Speiser, Dennis M. Styne, and Victor M. Montori

Professor Emeritus of Pediatrics, George Washington University School of Medicine (G.P.A.), Washington, D.C.; Yale University School of Medicine (S.C.), New Haven, Connecticut; Columbia University (I.F.) New York, New York; Duke University Medical Center (M.F.), Durham, North Carolina; Children's Hospital of Los Angeles (F.R.K.), Los Angeles, California; University of California San Francisco (R.H.L.), San Francisco, California; University of Florida (J.H.S.), Gainesville, Florida; Schneider Children's Hospital (P.W.S.), New Hyde Park, New York; University of California - Davis Medical Center (D.M.S.), Sacramento, California; and Mayo Clinic (V.M.M.), Rochester, Minnesota

Objective: To formulate practice guidelines for the treatment and prevention of pediatric obesity.

Participants: An Endocrine Society-appointed Task Force of experts, methodologist, and medical writer.

Evidence: This evidence-based guideline was developed using the Grading of Recommendations, Assessment, Development, and Evaluation system to describe the strength of recommendations and the quality of evidence, which was generally low or very low.

Consensus Process: Two group meetings, several conference calls, and e-mail communications enabled consensus. Committees and members of The Endocrine Society and Lawson Wilkins Pediatric Endocrine Society reviewed and commented on the preliminary drafts.

Conclusions: We recommend: defining overweight as BMI ≥85th percentile but <95th percentile, and obesity as BMI ≥95th percentile; against routine endocrine studies unless the height velocity is attenuated or inappropriate for the family background or stage of puberty; referring to a geneticist if there is evidence of a genetic syndrome; evaluating for obesity-associated co-morbidities in children with BMI ≥85th percentile; prescribing and supporting intensive lifestyle (dietary, physical activity, and behavioral) modification as the prerequisite for any treatment.






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