Health Care Resources
Obesity Prevention & Management
Clinical Guidelines & Tools
The latest expert panel recommendations from the American Academy of Pediatrics, this fact sheet includes appropriate billing codes for each of the five steps to prevent and treat childhood obesity.
This calculator—designed for children and teens between 2 and 20 years old—computes body mass index (BMI) and compares it to other children and teens of the same age and gender. It also has the option to enter multiple sets of measurements so that BMI can be viewed as a trend over time.
East Carolina University's Pediatric Healthy Weight Research & Treatment Center has developed an extensive medical nutrition therapy (MNT) protocol specifically for overweight children. The protocol provides guidance on topics to discuss with overweight children for a series of nutrition visits as well as patient education materials for each session. The latest version, posted in August 2008, includes updated resources, additional handouts and a brief summary of outcomes. The protocol incorporates the Expert Committee Recommendations on the Assessment, Prevention and Treatment of Child and Adolescent Overweight and Obesity.
Obesity and Overweight Toolkits
The California Association of Health Plans (CAHP) and the California Medical Association Foundation (CMAF) have released three toolkits to address obesity and overweight in three populations: adults, children/adolescents, and pre/post bariatric surgery patients.
~ Adult Obesity Provider Toolkit
The Maternal and Child Health Library at Georgetown University has compiled a selection of high-quality resources about the prevention, identification, management, and treatment of overweight and obesity in children and adolescents in homes, schools, and communities. Separate sections list resources for families, schools and after-school programs, and child care settings. The final section presents resources about the impact of media use.
Pediatric Weight Management Tools
There are many tools that can help health care providers better assess, prevent, and treat obesity in the office. Some are highlighted below.
~ Growth Chart Information : The Centers for Disease Control and Prevention provides extensive background information on the growth charts as well as numerous PDF examples of how to use them.
The Electronic Textbook allows easy access to information contained in "The Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults: The Evidence Report," produced by the National Heart, Lung, and Blood Institute (NHLBI) in cooperation with the National Institute of Diabetes and Digestive and Kidney Diseases. Topics addressed in the Clinical Guidelines include the health risks associated with overweight and obesity, as well as the assessment, treatment, and management of overweight and obese patients.
The online version can be read chapter to chapter, or you can quickly find a particular area of interest by using the search engine. Clicking on a specific chapter title gives you the option to choose specific sections or even sub-sections of the chapter. There are also links to tables, the treatment algorithm, references, and appendices within the body of the text. If you would like to print any text contained within this site, the Clinical Guidelines are also available in PDF format.
The Electronic Textbook also allows you to interact with the Overweight/Obesity Treatment Algorithm from the evidence report, a Menu Planner , a Body Mass Index Calculator , and the Evidence Model that was used to develop the guidelines and includes corresponding evidence statements and available evidence tables.
Expert Committee Recommendations Regarding the Prevention, Assessment, and Treatment of Child and Adolescent Overweight and Obesity
To revise 1998 recommendations on childhood obesity, an Expert Committee—comprised of representatives from 15 professional organizations—appointed experienced scientists and clinicians to 3 writing groups to review the literature and recommend approaches to prevention, assessment, and treatment of child and adolescent overweight and obesity. [Pediatrics. 2007 Dec; 120 Suppl 4:S164-92.]
NICHQ, the National Initiative for Children’s Healthcare Quality , has developed a toolkit to assist clinicians in providing quality care for children who are at risk for overweight, or overweight. This toolkit provides basics tools for primary care practice teams to deliver coordinated, integrated, and multidisciplinary services to both prevent overweight and improve care for children who are already overweight or at risk for overweight. Some of the NICHQ tools now available include:
~ Prevention Tools
This Guide was developed by a committee of North Carolina physicians and is based on the recommendations of the Expert Committee convened by the American Medical Association, in collaboration with the Health Resources and Service Administration and the Centers for Disease Control and Prevention (CDC). To complement the Pediatric Obesity Clinician Reference Guide, several other tools are provided: color-coded BMI charts, blood pressure tables, and prescription pads for promoting simple healthy messages for patients and their families.
This program is led by four institutes at the National Institutes of Health (NIH): the National Heart, Lung, and Blood Institute; the National Institute of Child Health and Human Development; the National Institute on Diabetes and Digestive and Kidney Diseases; and the National Cancer Institute. We Can! is unique in that it targets parents of youth ages 8-13 and caregivers and communities to improve nutrition, increase physical activity, and reduce screen time among kids to maintain a healthy weight. There are extensive resources available in English and Spanish for parents (parent handbooks and tipsheets), community leaders (community toolkit and evidence based programs for parent and youth programming), and health care providers (tip sheets for physicians on how to talk to parents and kids about maintaining a healthy weight).
The National Birth Defects Prevention Network's Education and Outreach Committee has compiled an educational packet containing materials with a special focus on obesity prevention and weight management before, during, and after pregnancy. Contents include pamphlets, posters, fact sheets, sample proclamations, news releases, letters, and lists of other resources. Many of the materials are available in English and Spanish.
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Patient Education Materials
Blue Cross/Blue Shield of North Carolina (BCBSNC) has developed a pilot program to empower families to help their children maintain healthy weights, adopt good nutrition habits, and get daily physical activity. The goals of the new program for children and families are to reduce children’s computer and TV screen time to less than two hours per day; increase their fruit and vegetable consumption to at least five servings per day; increase their physical activity to 60 minutes or more per day; and to reduce their consumption of sugared beverages. BCBSNC has provided a pediatric obesity benfit since 2007 that is fairly progressive; this may be a potential model for use with working with California insurers.
"Bright Futures" Programs
The Bright Futures for Infants, Children, and Adolescents Program is a national health promotion and disease prevention initiative that addresses children's health needs in the context of family and community. In addition to use in pediatric practice, many states implement Bright Futures principles, guidelines, and tools to strengthen the connections between state and local programs, pediatric primary care, families, and local communities. Whether you are a health care or public health professional, a parent, or a child advocate, Bright Futures offers many different resources for your use in improving and maintaining the health of all children and adolescents.
The following are "Bright Futures for Infants, Children, and Adolescents" obesity-related handouts:
~ Bright Futures Promoting Healthy Weight Handout
The mission of the Bright Futures for Women's Health and Wellness Initiative (BFWHW) is to plan, develop, implement, and evaluate a variety of culturally competent, evidence-based consumer, provider, and community tools for women across their lifespan. Materials help women of all ages achieve better physical, emotional, social, and spiritual health by encouraging healthy practices.
The following are "Bright Futures: Women's Health" obesity-related handouts:
~ My Bright Future: Physical Activity and Healthy Eating for Rural Adult Women
Developed by the USDA, these 16 nutrition messages were designed for use in the Federal nutrition assistance programs and to reach and resonate with low-income mothers and 8- to 10-year-old children. The consumer-tested messages have application across Federal nutrition assistance programs and can help nutrition educators deliver consistent and accurate messages that support national goals and the development healthy eating patterns in young children.
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Physician/Health Care Provider Advocates
NPLAN Releases New Obesity Prevention Resolution
The National Policy and Legal Analysis Network (NPLAN) released two new products: a model obesity prevention resolution and a fact sheet that explains the value of putting such a resolution in place. NPLAN's model resolution is designed to help communities implement policies that address the obesity epidemic by improving physical activity environments, healthy food access, and disparities in their community. It also recommends how to promote obesity prevention policies in their schools, parks and recreation, community and day care centers, the food and beverage industry, hospitals, and the workplace.
Tips for finding and including health care professionals in the development and implementation of school wellness committees. Prepared by the Orange County Nutrition Services Department.
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Reimbursements for Weight Management & Prevention
Pay Now or Pay Later: Financing Childhood Obesity Prevention and Treatment
Reimbursement for medical services related to childhood obesity is emerging as a major issue surrounding childhood obesity care throughout the United States. The December 2008 "Q-Call" (teleconference) sponsored by the National Initiative for Children's Healthcare Quality (NICHQ) addressed the current state of reimbursement for childhood obesity services through the lens of NICHQ's Childhood Obesity Action Network's key findings in a recently released report. The guest speakers explored what the public and private sectors are doing to pay for obesity-related services and discussed innovative approaches to improve the health system's response.
~ REPORT: Childhood Obesity: The Role of Health Policy . This report to the Second National Childhood Obesity Congress in Miami (2008) summarizes key findings of a two-year effort to garner new learning and develop new collaborations to address the issues of childhood obesity.
The Task Force on Obesity, the Committee on Coding and Nomenclature, and the Private Sector Advocacy Advisory Committee developed this fact sheet to help pediatricians and other health care professionals with coding for obesity-related health care services.
The American Academy of Pediatrics' online home for the best pediatric practice management information, tools, and resources for pediatricians and their office staff.
Strategies for Improving Access to Comprehensive Obesity Prevention and Treatment Services for Medicaid-Enrolled - Policy Brief
Prepared by researchers at the George Washington University School of Public Health and Health Services, this report examines the extent to which state programs use the Medicaid EPSDT benefit to address and finance obesity-related services that advance best-practice standards in obesity prevention, treatment, and management in children.
Analysis Shows Existing Medicaid Benefit Codes Cover Childhood Obesity-Related Health Care Treatment
Summary document of two studies analyzing whether (1) Medicaid could cover preventative health services for children at risk for obesity; and (2) Medicaid's payment practices support recommended clinical practice.
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QuIIN is a program at the American Academy of Pediatricians (AAP) that involves a network of practicing pediatricians and their staff teams who use quality improvement methods to test tools, interventions, and strategies in order to improve healthcare and outcomes for children and their families.
COAN is a Web-based national network, coordinated by the National Initiative for Children's Healthcare Quality aimed at rapidly sharing knowledge, successful practices, and innovation by:
~ Mobilizing and inspiring health care providers to accelerate improvements in care and advocate for change
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Ten Years of Research on Sugar Sweetened Beverages cwh
Lorrene Ritchie, Director of Research, The Dr. Robert C. and Veronica Atkins Center for Weight and Health, U.C. Berkeley, recently spoke on "Ten Years of Research on Sugar Sweetened Beverages and Obesity: Where We Have Been?… Where We Are Going?" Read her presentation.
The American Academy of Pediatrics has posted a number of presentations and webinars created by several of its fellows. These presentations are not official Academy publications or policy. You may use the content in the presentation slides as long as you reference the author and presentation as appropriate. Titles include:
~ Weight Management for Pediatric Patients: Expert Committee Recommendations
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The "Speaking Together" Toolkit offers detailed guidance for building a high quality language services program in a health care setting. Each section of the toolkit includes steps that guide management of operations and provides strategies to improve services in many care settings. It provides the information and resources you need to:
~ Identify individuals, strategies, and tools to build and improve language services;
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Weight Management Programs
KidShape is a 9-week, family-based, pediatric weight management program that builds healthy families. KidShape teaches the entire family how to eat more nutritiously, make exercise a fun part of the daily routine, form new healthy habits, and to like themselves, regardless of size. A team of health experts consisting of a Registered Dietitian, a mental health professional, a physical activity expert, and a health educator administers the KidShape program. All KidShape programs are family-based. Each program incorporates hands-on activities to empower youth and adults to eat healthy, move more, and feel good.
The American Dietetic Association (ADA) provides a searchable database to find professional nutritional services in your area. The database includes registered dieticians (RD) and dietetic technicians (DTR). According to the ADA, individuals with these credentials have completed specific academic and supervised practice requirements, successfully completed a registration examination, and maintained requirements for recertification. Some RDs or DTRs call themselves nutritionists. However, the definition and requirements for the term "nutritionist" vary. Some states have licensure laws that define the scope of practice for someone using the designation nutritionist.
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