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One-Minute Advice for Providers

For children with a normal BMI
Encourage the child to:

• Limit TV/video to one hour per day and read more.
• Eat five helpings of fruits and vegetables each day.
• Limit soda, fruit juice to one small cup per day.

For children with a BMI between 85-95 percent and children crossing percentiles

1. Engage the child and parent
   • Can we take a few minutes together to discuss your child’s health and weight?
   • (Child) What do you think about your weight?
   • (Parent) What to you think about your child’s weight?
2. Share information
   • Overweight children are at increase risk for heart disease and diabetes. What do you make of this?
   • Some ideas for weight management and good health include increasing physical activity and better nutrition: What are your ideas for working towards a healthier weight for your child?
3. Make key advice statement—I would strongly encourage you to:
   • Decrease TV/video watch to one hour per day (or incremental decreases).
   • Limit soda, juice and whole milk.
   • Maintain current weight, don’t gain more weight (except for group with co-morbidities).
4. Arrange for follow-up:
   • Would you be interested in some information on ways to work towards a healthier weight?
   • Let’s make an appointment with an MD, RD, or other clinician.
   • Let’s recheck weight in one month.

For children with a BMI above 95 percent or children with a lower BMI and obesity-related co-morbidities
Review above plus:

• Screen with fasting serum glucose, insulin, HgbA1c, AST, ALT, and lipid panel.
• Consider behavioral modification techniques such as contract and rewards.
• Referral to an obesity treatment program if available and patient demonstrates a readiness to change.

References

1. Obesity Evaluation and Treatment: Expert Committee Recommendations
   Barlow, S. and Dietz, W.
2. Prevention of Pediatric Overweight and Obesity
   American Academy of Pediatrics Policy Statement
   Pediatrics, 112:2,424-430
3. Preventing Childhood Obesity: Health in the Balance
   Institute of Medicine Report, 2005
4. Effective Communication with Families
   Gee, S.; Ravel, J.; Roberts, S.; and Wylie, A.
   Regional Health Education-Kaiser Permanente Northern California
   (http://nature.berkeley.edu/cwh/PDFs/CCOC_05_PDFs
   /S_Gee_effectivecommunication2.pdf)

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