In the United States, nearly 1 in 3 children are overweight or obese.1 Most pediatricians see obese children every day in their practices. One cannot just ignore the problem hoping it will disappear. How do you treat them? What do you recommend? In this era of evidence-based medicine, why do we know so little about how to successfully treat such a common and important problem?
In March 1997, the Maternal and Child Health Bureau of the Health Resources and Services Administration convened a small group of clinicians and researchers for 2 days to review the available evidence and develop “expert committee recommendations” for evaluating and treating pediatric obesity.2 It was openly acknowledged that “Because so few studies of this problem have been performed, the approaches to evaluation and therapy presented here rarely are evidence-based.”2(p1) The resulting recommendations, however, were frequently cited as useful guides for treatment while awaiting additional relevant evidence.
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