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MULTIDISCIPLINARY AND COMMUNITY-BASED MANAGEMENT.

Posted May 17 2009 11:44pm
This treatment modality includes Community-based programs to inform families regarding
  •         Age-appropriate healthy eating choices,
  •         Meal and portion size planning,
  •         Decreasing “screen time,”
  •        Approaches to increasing physical activity

These measures will provide an important service for families with children at risk for becoming overweight or mildly to moderately overweight without comorbidities. extremly overweight children and teens with complications from obesity are best managed by a multidisciplinary team. The treatment models used in most pediatric centers feature family-based behavioral treatment, which is the only approach shown to have long-term efficacy. Teams may include a physician, a psychologist, a dietitian, an exercise specialist (physical therapist, exercise physiologist, educator), a nurse, and counselors. Management consists of dietary counseling, exercise therapy, and behavioral management. Psychologists screen families for underlying problems that have led to a child's overweight, problems arising from health complications of overweight, and barriers to successful adaptation of a healthier lifestyle. Once problems are identified, psychologists and counselors can use cognitive behavioral and family therapy to address such issues. Methods used include positive reinforcement, changes in the home and family environment, self-monitoring, goal-setting, contracting, and parenting skills training. Comorbid conditions, such as eating disorders, depression, and anxiety, can be more effectively treated in the multidisciplinary setting. Exercise specialists can help overweight children exercise in age-appropriate, fun ways, as well as compensate for deficiencies arising from being overweight, such as deconditioning, orthopedic conditions (Blount disease, slipped capital femoral epiphysis), or muscular weakness. Formal rehabilitative therapy is sometimes required in very overweight patients due to years of inactivity with muscle deconditioning combined with orthopedic problems.


At a societal level, obesity must also be addressed in schools, by industry, and by the government
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