Obesity Prevention in Primary Care

The Institute of Medicine Committee on Prevention of Obesity in Children and Adolescents (Washington, DC) recommended that child health professionals routinely monitor and track body mass index (calculated as weight in kilograms divided by the square of height in meters) and offer relevant evidence-based counseling and guidance to improve nutrition, increase physical activity, and decrease sedentary behaviors.¹ Recent surveys indicate that child health care professionals often fail to diagnose childhood obesity, only inconsistently use body mass index and the Centers for Disease Control and Prevention (Atlanta, Ga) body mass index charts² and/or provide nutrition and physical activity counseling, and report low levels of confidence, proficiency, and effectiveness in evaluating and managing childhood obesity.^3- 7 In addition, there is little evidence to support specific intervention strategies for primary care professionals.^1,8 It is in this context that Patrick and colleagues⁹ report the results of a randomized controlled trial of Patient-centered Assessment and Counseling for Exercise + Nutrition (PACE+), a primary care–initiated intervention to improve diet, physical activity, and sedentary behaviors, in 819 11- to 15-year-olds, 438 girls and 381 boys, in this issue of the ARCHIVES. The intervention was designed to overcome many of the perceived barriers for providing obesity evaluation and counseling in the office setting by using computer-based screening and goal-setting algorithms, requiring only limited health care professional time for training (2 hours) and patient counseling, and using non–health care professional staff for continuing follow-up assessments and counseling.