The pediatric multidisciplinary obesity program: An update

The dramatic increase in obesity over recent decades has been well documented. In response, the need for pediatric multidisciplinary obesity programs when efforts within the primary care setting fail to produce the desired results has been recognized. This review describes the components, outcomes, barriers and future of pediatric multidisciplinary obesity programs. These programs are able to offer preventive care, medical weight management programs, medications, and bariatric surgery. A team of physicians, dietitians, health educators, exercise physiologists, surgeons, and psychologists usually delivers services, each with varying proportions of involvement. Interventions are provided to participants at individual visits, group sessions or a combination of both. The majority of programs report very modest decreases in anthropometric measures, with improvements in metabolic and cardiovascular risk factors. However, the long-term impact of slowing a child's growth trajectory for a significant amount of time is not well known and demands further study. Challenges faced by the pediatric multidisciplinary obesity program include poor reimbursement, lack of evaluation and outcomes data, low parental and child motivation, and high attrition rates. As the number of pediatric multidisciplinary obesity programs increases, their relevance will be largely determined by i) efficacy of the intervention; ii) the need for their services; and iii) support from families, healthcare providers, the community, and public policies. (C) 2008 Elsevier Ireland Ltd. All rights reserved.