5. Management of Overweight Children and Adolescents

Complications

For those with complications, improvement or resolution of the condition is an important goal. For example, an abnormal blood pressure or lipid profile may improve or return to within a normal range with weight management.

Acute complications such as sleep apnea and pseudotumor cerebri should be referred to a pediatric obesity center (Barlow and Dietz, 1998). Orthopedic problems should be referred to an orthopedist.

Individualized Recommendations

Each family has its own set of supports and stresses. Because success with weight management can be difficult to achieve, recommendations for change must consider the family's readiness for change, family support, financial concerns, and neighborhood characteristics (including access to play areas and grocery stores). Unless the situation is understood fully, recommendations for change may not be targeted appropriately.

Treatment should begin early, involve the family, and institute permanent changes in a stepwide manner. Parenting skills are the foundation for successful intervention -- that include gradual targeted increase in physical activity and targeted reductions in high-fat and high-calorie foods.