Pediatric Obesity Guideline Resources

Full Guideline: Pediatric Obesity— Assessment, Treatment, and Prevention
JCEM | January 2017
Dennis M. Styne (chair), Silva A. Arslanian, Ellen L. Connor, Ismaa Sadaf Farooqi, M. Hassan Murad, Janet H. Silverstein, and Jack A. Yanovski

The Endocrine Society's 2017 guideline is an update of the previous version from 2008. This guideline addresses:

  • Preventing and treating childhood obesity with lifestyle changes
  • Evaluating affected children for medical or psychological complications
  • Deciding when to evaluate children for rare genetic causes of obesity
  • Determining when medication or surgery is appropriate for severely affected adolescents


Resources



Essential Points

  • Children or teens with a BMI greater than or equal to the 85th percentile should be evaluated for related conditions such as metabolic syndrome and diabetes.
  • Youth being evaluated for obesity do not need to have their fasting insulin values measured, because it has no diagnostic value.
  • Children or teens affected by obesity do not need routine laboratory evaluations for endocrine disorders that can cause obesity unless their height or growth rate is less than expected based on age and pubertal stage.
  • Specific genetic testing should be considered when there is early onset obesity (before 5 years old), an increased drive to consume food (extreme hyperphagia), other clinical findings of genetic obesity syndromes, or a family history of extreme obesity.

Summary of Changes

  • Updated references and epidemiology
  • Increased emphasis on the limitations of applying BMI calculations to all ethnic groups.
  • Endocrine evaluations and insulin values may not be necessary for most children. Evaluation section discusses appropriate laboratory testing and how to avoid unnecessary tests.
  • The genetics section has been extensively revised and includes a flow chart for evaluation children with early onset obesity, family history of extreme obesity, and hyperphagia for genetic factors.
  • Previous lifestyle recommendations for prevention and treatment continue to be supported, but breast-feeding as prevention has been downgraded from a recommendation to a suggestion based on recent data.
  • The psychological factors affecting childhood obesity are discussed, as well as the toll it takes on children.
  • Information on the risks, contraindications, and recommendations for medication and surgery for severely affected adolescents has been added, including a discussion on bariatric surgery.
  • Goals for future research has been updated.

Summary of Recommendations

+ 1.0 Diagnosing overweight and obesity

+ 2.0 Genetic obesity syndromes

+ 3.0 Prevention of obesity

+ 4.0 Treating obesity