The percentage of overweight children in the United States is growing at an alarming rate. On the whole, kids are spending less time exercising and more time in front of the TV, computer, or video-game console. And today’s busy families have fewer free moments to prepare nutritious, home-cooked meals, day in and day out. From fast food to electronics, quick and easy seems to be the mindset of many people, young and old, in the new millennium.Treatment of Overweight

Overweight and obesity are rapidly increasing health problems, leading to considerable co-morbidity and increased mortality. In this article a Dutch guideline is proposed for the management of overweight and obesity, which in part is based on North American and European treatment proposals. After having assessed the degree of overweight and associated health risks, based on medical history, physical examination and laboratory investigations, a decision to start treatment can be made. First, consensus with regard to treatment goals has to be reached between doctor and patient, who has to be motivated to change his or her lifestyle. A modest (5-15% of pre-treatment weight) weight loss, which has to be sustained in the long term, is a desirable, realistic and achievable treatment goal for the majority of patients.

Medical Care System

The pervasive nature of the obesity problem calls for an immediate and active role in treatment for the medical care system. A key challenge to treating obesity is shifting the paradigm that has characterized disease management in which the patient is a passive recipient of care. A new paradigm must focus on patient self-management interventions. Organizations like Kaiser Permanente and HealthPartners have been actively promoting the understanding of how to increase the effectiveness of programs for management of the severely obese. However, the “medicalization” of the obesity problem is not the most effective strategy. Participants acknowledged that solutions should be based on a public health approach that has a strong foundation outside the medical care system. Discussion focused on the need for models of collaboration at the local level between medical care systems, public health systems, and community organizations.

Dietary Treatment for Overweight

Stearns asserted that the contemporary obsession with fat arose in tandem with the dramatic growth in consumer culture, women’s increasing equality, and changes in women’s sexual and maternal roles. Dieting, with its emphasis on deprivation, self-control, and moral discipline, seemed the perfect antidote to the indulgence of consumer culture, and Stearns contended that “weight morality bore disproportionately on women precisely because of their growing independence, or seeming independence, from other standards.”

Treatment of Overweight in Childhood

# Review current data on the rising incidence of overweight in children and adolescents.
# Understand the health risks of overweight, including the psychosocial issues and increased incidence of adulthood obesity.
# Appropriately diagnose overweight and its co-morbidities in the pediatric population.

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