Pediatric Obesity Algorithm®
The Pediatric Obesity Algorithm was developed by practicing pediatricians and clinicians who treat obesity in infants, children, and adolescents. It combines scientific evidence, medical literature, and clinical experience into one document to educate clinicians and help them implement evidence-based practices. Clinicians can use the Pediatric Obesity Algorithm as a resource when making treatment recommendations or when referring their patients to childhood obesity specialists.
The Obesity Algorithm® is a clinical tool to help health care providers both understand the complexity of the disease of obesity and implement effective, evidence-based obesity treatment strategies with their patients.
AAP's Institute for Healthy Childhood Weight
The Institute for Healthy Childhood Weight serves as a translational engine for pediatric obesity prevention, assessment, management, and treatment, and moves policy and research from theory into practice in American healthcare, communities, and homes.
Childhood Obesity Research Demonstration Project
CORD (Childhood Obesity Research Demonstration) project is a CDC-funded project to look at different community-based levels of intervention in Texas, Massachusetts, and California. Provides references and outcomes discussions from the studies.
USDA resource for wellness advocacy in schools and resources for families.
Center for Healthy Weight and Nutrition
The Center for Healthy Weight and Nutrition has developed several tools intended to provide primary care physicians with practical guidance on the approach to the child with obesity.
Rudd Center for Food Policy and Obesity
Rudd Center for Food Policy & Obesity has great pediatric information, sensitive pictures, guidelines for media, etc. In addition, there are full text articles available for any manuscripts that the Center’s researchers produce, which is very helpful for those without access to an academic library.
Parenting at Mealtime and Playtime Learning Collaborative
The Parenting at Mealtime and Playtime (PMP) Learning Collaborative offers resources to pediatric practices to help counsel families of infants and young children (ages birth to 5 years) about good nutrition and positive parent-child interactions during mealtime and playtime. This quality improvement program provides tools for physicians to enhance prevention counseling strategies, become adept at assessing “risk,” and intervene at the earliest possible stage before a child develops overweight or obesity.
CHAMPS Overweight and Obesity Treatment and Prevention Resources
Site provided as a resource for community health centers in western regions with a list of provider and family resources for obesity treatment and prevention.
Healthy Active Living for Families
The Healthy Active Living for Families (HALF): Right from the Start program is a project developed by the American Academy of Pediatrics to address early childhood obesity prevention that integrates the parent perspective and evidence-informed pediatric health guidance.
National Institutes of Health We Can!® Campaign
Resource for providers with templates for talking with patients about obesity and prevention, as well as handouts, posters, and other resources.
Childhood Overweight Fact Sheet
The Obesity Society’s fact sheet on obesity in pediatrics.
ChopChop for Doctors
ChopChop is a quarterly cooking magazine and website for kids and their families. The print edition is given out by doctors to children and their parents as part of pediatric visits to promote healthy eating and cooking together. Available in English and Spanish.
The Dr. Yum Project
In response to the growing rates of childhood obesity, pediatrician Nimali Fernando MD, MPH, started doctoryum.org in 2011 to teach her patients and her families about the benefits of healthy eating. What started out as a recipe and parenting site grew to a bigger project of teaching a healthy lifestyle to the greater community. In 2012, The Dr. Yum Project, a 501 (c)3 organization, was born.
Focus on a Fitter Future: A Survival Guide for Planning, Building, and Sustaining a Pediatric Obesity Program
Provided by the Children’s Hospital Association as a template for developing an obesity program.
Children's Healthcare of Atlanta
The provider page of Children’s Healthcare of Atlanta is a great resource for a wide range of obesity interventions with provider and patient resources.
Nutrition, Physical Activity, and Obesity: Data, Trends, and Maps
Keep up to date with nutrition, physical activity, and obesity data. CDC’s Division of Nutrition, Physical Activity, and Obesity (DNPAO) has made important updates to the Data, Trends and Maps database.
Alliance for a Healthier Generation
The Alliance for a Healthier Generation and Voices for Healthy Kids are working to elevate the importance of strong wellness policies in schools. The #WellnessWins campaign celebrates district wellness success and inspires everyone to create healthier school environments grounded in strong wellness policies. School leaders, community members, and parents can visit WellnessWins.org to download resources, read success stories, and learn how to support and advance school wellness policies.
BCBS of Tennessee Childhood Obesity Toolkit
Blue Cross Blue Shield of Tennessee toolkit for providers with resources and references.
Healthy Eating and Living Education (HEALED) Program
The Healthy Eating and Living Education (HEALED) program provides primary care physicians and staff with efficient, evidence-based strategies for the assessment, prevention, and treatment of pediatric obesity.
Obesity Action Coalition: Understanding Obesity in Children
Better understand obesity in children, its causes, and how to measure it. Find resources for combating bullying and childhood obesity stigma.
Weigh In: Talking to Your Children about Weight + Health
Sponsored by the STOP Obesity Alliance and the Alliance for a Healthier Generation, this site provides guidance on talking with children about weight and scenarios to help guide discussions for parents and children.
AAP-sponsored website with resources for parents on a wide range of topics, including obesity, healthy eating, and active play.
Let's Move! Child Care Resources for Parents
Parent resources for use at home or when talking with your child care providers about their programs. Help your family eat healthier, get your kids moving, limit screen time, and get breastfeeding support.
The Dr. Yum Project
A site founded by a pediatrician, which provides links to recipes, tips for cooking with children, and many more healthy, active living resources.
My Munch Bug
Pediatric feeding expert with tips for picky eaters and parent coaching.
National Institutes of Health parent resource for understanding and preventing obesity.
The Nutrition Source
The Nutrition Source is a leading authority on food and nutrition knowledge, providing science-based guidance for healthy living. It is provided by the Harvard T. H. Chan School of Public Health’s Department of Nutrition.
Children's Healthcare of Atlanta
Children’s Healthcare of Atlanta provides a comprehensive site for parents on both treatment and prevention of obesity.
Parenting at Mealtime and Playtime
The Ohio AAP provides resources for both providers and parents in the fight against obesity. The site has links to easy-to-use mobile device applications as well as nutrition and physical activity resources.
Pediatric Obesity Research Updates
Each month, the pediatric committee posts a pediatric-focused obesity research update to help keep you up to date about the latest findings.
Tracking of BMI z Scores for Severe Obesity
Freedman, D. S., and Berenson, G. S. Pediatrics, 2017. View the article here.
Freedman and Berenson’s study examined almost 7,000 children (ages 2-17) who were part of the Bogalusa Heart Study. These children had multiple examinations (total = 24,603) between 1977 and 1992. The mean interval between examinations was 2.8 years. The focus of the study was on the subset of children with severe obesity (%BMIp95>120%). This subset was 247 children.
The authors compared three BMI metrics: BMI for sex/age a score (BMIz), BMI expressed as a percentage of the 95th percentile (%BMIp95), and levels of BMI z score adjusted for the compression of very high z scores (adjusted z score [BMAaz]). As we know, the BMIz score has an upper limit due to the BMI percentiles maxing out at 95%, while the %BMIp95 and the BMIaz do not have upper limits.
The sample size of the children with severe obesity was older (mean difference of 10 months), was more likely to have been examined in the later years of the study, and was more likely to be African-American. The mean age of the children with severe obesity was 11.7 years, the mean BMI was 32 kg/m2, the mean BMIz was 2.4 SDs, and the mean BMIaz was +3.0 SDs.
The authors found that when they compared the differences between the metrics longitudinally, the correlation for BMIz was consistently weaker than that for BMI, BMIaz and %BMIp95. The BMIz was especially weak for children younger than 10 years. The authors point out that the BMIz is compressed at higher levels; in other words, large increases in BMI in children with severe obesity are not associated with large increases in the BMIz, thus a child could actually have increased their BMI over time but decreased their BMIz score.
The authors recommend that if we are going to track children with severe obesity longitudinally, we use either %BMIp95 or BMIaz. If the population has a wide range of BMI values, then the BMIaz may have a stronger correlation than the %BMIp95. If we are looking mainly at children with severe obesity, the %BMIp95 is the better metric.
This article redefines how we track pediatric patients with obesity through treatment. The change in the percentage of the 95th percentile allows us to compare weight change in patients at different ages and sexes, which we were unable to do using the BMI z score. Previously, researchers could report a decrease in BMI z score secondary to treatment, which was meaningless due to averaging the change in BMI z score over children with obesity from young ages (3-5) through adolescence. Now, we have a metric that allows much more meaningful tracking. Further research will elucidate how much of a change in the percent BMI over the 95th percentile results in clinically meaningful improvement in cardiovascular risk factors and progression to T2DM. Preliminary results point to a change of 5-10%.