How to tackle the problem early? The role of education in the prevention of obesity

The major issues that confront the clinician in relation to childhood obesi ty are identifying children at risk, deciding the goal and focus of therapy , and determining how to maintain weight loss. The severity of obesity and the age at which it is present appear to be significant determinants of whe ther childhood obesity will persist into adulthood. At any age, severe obes ity is more likely to persist, and obesity present in adolescents is much m ore likely to persist than obesity in young children. If a child has obese parents, the risk that their obesity will persist to adulthood increases, t hough the magnitude of that risk varies with the age of the child. The goal s of therapy depend on the child's age and the severity of obesity-related complications. Assessment of the family's readiness to change represents th e first focus of therapy. A reduction in time spent watching television, co upled with family involvement and a diet that aims to reduce or eliminate h igh caloric density foods is the best approach in most cases. Children or a dolescents who have an emergent complication of obesity are candidates for aggressive weight reduction such as the protein modified fast. More aggress ive therapies, such as drug therapy or gastric bypass surgery, must be cons idered as experimental in children and adolescents.