Evidence-Based Guidelines for Child Obesity

What to know

Many professional associations offer evidence-based guidelines for comprehensive care for children with obesity. The guidelines include obesity screening and referral to effective obesity interventions. These guidelines inform pediatricians and other pediatric health care providers about the standard of care for screening, evaluating, and treating obesity and related chronic diseases.

female doctor and young male patient looking at clipboard

American Academy of Pediatrics

In 2023, the American Academy of Pediatrics (AAP) released the Clinical Practice Guideline (CPG) for the Evaluation and Treatment of Children and Adolescents With Obesity.

The AAP CPG recommends that pediatric health care providers (PHCPs) screen all children 2–18 years for overweight, obesity, and severe obesity at least annually. To do so, they should:

  • Measure height and weight.
  • Calculate body mass index (BMI).
  • Assess BMI percentile using age- and sex-specific CDC growth charts.

The AAP CPG also provides guidelines on how to treat and manage obesity. This includes guidelines for offering or referring patients to intensive health behavior and lifestyle treatment.

Weight stigma‎

Stigma toward people with obesity is common. It contributes to binge eating, social isolation, avoidance of health care services, decreased physical activity, and other unhealthy behaviors. The AAP recommends several strategies for reducing weight stigma, including modeling non-biased behaviors, using person-first language, and counseling using empathetic techniques.

US Preventive Services Taskforce (USPSTF)

In 2017, the USPSTF recommended that clinicians:

  • Screen for obesity in children and adolescents 6 years and older, and
  • Offer or refer them to comprehensive, intensive behavioral interventions to promote improvements in weight status.

This recommendation was Grade B. This means there was moderate certainty that the net benefit was moderate. USPSTF found no direct evidence of harm in screening for obesity. This recommendation was based on a thorough evidence review of behavioral interventions for obesity targeting lifestyle change.

Other organizations

American Psychological Association
In 2018, the association released the Clinical Practice Guideline for Multicomponent Behavioral Treatment of Obesity and Overweight in Children and Adolescents. This CPG strongly supported the use of family-based multicomponent behavioral interventions with at least 26 contact hours for children and adolescents 2-18 with overweight and obesity.

Pediatric Endocrine Society
In 2017, the society convened a task force of experts who released a clinical practice guideline titled Pediatric Obesity- Assessment, Treatment, and Prevention. It includes BMI screening, evaluating children with overweight or obesity for obesity-related comorbidities, and referring to intensive family-centered lifestyle programs.

Resources

CDC-Recognized Family Healthy Weight Programs
Evidence-based programs ready to implement in clinical, community, and public health settings.

CDC's Child and Teen BMI Calculator
Tool to calculate BMI, BMI percentile, and the corresponding BMI category for children and teens aged 2–19 years, as well as plot the BMI on a growth chart.

CDC's Growth Chart Training
Interactive, self-guided modules to train health care providers and others on how to use and interpret growth charts, including CDC's 2022 Extended BMI-for-Age growth charts.

Clinical Growth Charts
CDC's 2000 and 2022 growth charts available online or in downloadable format.