1st Edition

Handbook of Pediatric Obesity Clinical Management

    416 Pages 15 B/W Illustrations
    by CRC Press

    A compilation of management, medical, nutrition, psychological, and physical activity facts, models, theories, interventions, and evaluation techniques, the Handbook of Pediatric Obesity: Clinical Management is the most clinically appropriate and scientifically supported source of information available for pediatric health care and research professionals. This comprehensive, state-of-the-art, and easy-to-use reference can be used to develop programs that provide the best possible care to overweight children in clinical settings.

    Melinda Sothern is co-winner of the 2009 Oded Bar-Or Award for Excellence in Pediatric Obesity Research sponsored by the Obesity Society Pediatric Obesity Section

    Covering clinical evaluation, medical aspects of treatment, and psychosocial, behavioral, nutritional, and physical activity considerations, the book discusses approaches to weight management such as diet, behavioral counseling, exercise, pharmacology, and surgery. It presents coverage of applied techniques, information, and tools for developing, modifying, implementing, and evaluating weight-management programs for children and adolescents in clinical settings. Worksheets, menu plans, and sample exercise programs are just a few of the features that make this book practical as well as informative.

    It is clear that there is no single solution for every overweight child and the number of options can seem overwhelming. This text provides clinicians with the information and tools necessary to match or tailor the available treatment plans to the medical, physical, nutritional and emotional needs of their patients.

    Clinical Management of Pediatric Obesity: An Overview, D.M. Styne
    References

    Clinical Management

    The Business of Weight Management, M.S. Sothern


    Introduction
    The Planning Process
    Designing Health Promotion Interventions
    Implementing a Health Promotion Program
    Evaluating a Health Promotion Program
    Summary
    References
    Medical Aspects of Treatment
    Medical Complications and Comorbidities of Pediatric Obesity, M.S. Jacobson
    Genetic Syndromes Associated with Childhood Obesity
    Endocrine Disorders
    Cardiovascular Complications
    Insulin Resistance Syndromes
    Gastrointestinal System
    Pulmonary Complications of Obesity
    Neurological
    Orthopedic
    References
    Medical Aspects of Treatment: The Role of the Physician, S.T. Gordon
    Introduction
    Role of the Primary Care Practitioners
    The Role of the Physician in the Treatment of Overweight Youth
    Conclusion
    References
    Psychosocial and Physical Considerations
    Psychosocial Considerations during Treatment, J. Schwimmer
    Introduction
    Underlying/Comorbid Psychopathology
    Family Psychosocial Issues
    Psychosocial Consequences
    Psychosocial Tools
    Conclusion
    References
    Weaknesses and Strengths in the Response of the Obese Child to Exercise, C. VanVrancken-Tompkins, M.S. Sothern, and O. Bar-Or
    Introduction
    Responses of the Obese Child to Exercise
    Implications of Exercise Prescription
    Summary
    References

    Clinical Evaluation


    Clinical Evaluation: Diagnosis, Medical Testing, and Follow-up, N.F. Krebs, and M.S. Sothern
    Prevalence
    Causes/Risk Factors
    Comorbidities
    Treatment Approaches
    Diagnosis
    Referrals
    Education
    Follow-Up
    Summary
    References
    Nutritional Assessment of the At-Risk for Overweight and Overweight Child and Adolescent, N. Copperman
    Introduction
    Home Environment Assessment
    School Environment Assessment.
    Community Environment Assessment
    Physical Activity Assessment
    Psychosocial Assessment
    Dietary Intake Assessment
    Physical and Laboratory Assessments
    Nutritional Care Plan and Case Management
    References
    Behavioral and Psychosocial Assessment Tools, S. Johnson, and T.K. von Almen
    Behavioral Assessments
    Psychosocial Assessments
    Self Esteem
    Anxiety
    Measures of Eating Disorders
    Family Measures
    Conclusion
    References

    Exercise Testing, T. Rowland, and M. Loftin


    Physiological Considerations
    Cardiovascular Fitness
    Autonomic Function
    Blood Pressure
    Ventilatory Anaerobic Threshold
    Running/Walking Economy
    References

    Dietary Approaches


    Pediatric Obesity Dietary Approaches in Clinical Settings: A Survey of the Options and Recommendations, M.S. Sothern, C. VanVrancken-Tompkins, and L.K. Carlisle
    Introduction
    VLCDs in the Clinical Setting
    References
    Nutrition Education, H. Schumacher, C. VanVrancken-Tompkins, and M.S. Sothern
    Introduction
    Nutrition Education and Individual Counseling
    Nutrition Education and Group Counseling
    Nutrition Education in Multidisciplinary Settings
    Nutrition Education and Alternative Dietary Approaches
    A Sample Nutrition Education Curriculum in the Clinical Setting
    Summary
    References

    Behavioral Counseling


    Behavioral Counseling: Family-Based Behavioral Counseling in Clinical Settings, P. Davis Martin, and V.H. Myers
    Behavioral Treatment Techniques
    Overview of Family-Based Studies
    Parent Training or Modeling Interventions
    Individual Treatment Approaches
    Summary
    References

    Exercise and Physical Activity


    Increasing Physical Activity in Overweight Youth in Clinical Settings, C. VanVrancken-Tompkins, C. Brooks, C. Thélin, and M.S. Sothern
    Introduction
    Motivational Theories and Models
    Motivational Techniques to Increase Physical Activity
    Summary
    References
    Exercise and Physical Activity: Exercise Training Programs and Metabolic Health, S. Owens, PhD
    Introduction
    Components of Metabolic Health in the Pediatric Obesity/Exercise Literature
    Effects of Exercise on Components of Metabolic Health
    Summary of Components of Successful Exercise Programs
    References

    Internet-based Approaches


    Internet-Based Treatment for Pediatric Obesity, D.A. Williamson, H. Walden, E. York-Crowe, and T.M. Stewart
    Background
    Utilization of the Internet for Weight Management
    HIPTeens
    Summary and Conclusions
    References

    Pharmacology


    Pharmacologic Treatment of Adolescent Obesity, C.E. Crerand, T.A. Wadden, and R.I. Berkowitz
    Introduction
    Pharmacological Agents for the Treatment of Obesity
    Use of Orlistat with Adolescents and Children
    Use of Sibutramine with Adolescents
    Metformin
    Clinical Implications and Conclusions
    References

    Surgery


    Surgical Management of Pediatric Obesity, T. Inge, M. Zeller, S. Kirk, and S. Daniels
    Introduction
    Primary Care Provider Considerations before Referral of Surgical Candidates
    Comprehensive Team Assessment of the Patient Referred for Bariatric Surgery
    Postoperative Management
    Final Words of Caution
    Summary
    References
    Interdisciplinary, Interactive, Group Instruction
    Interdisciplinary, Interactive Group Instruction: Orientation, Evaluation and Monitoring Progress, L.K. Carlisle, and S.T. Gordon
    Introduction
    Orientation
    Evaluation
    Monitoring Progress
    Summary
    References
    Interdisciplinary, Interactive, Group Instruction, T.K. von Almen, M.S. Sothern
    Behavioral Therapy: Group Counseling Sessions, Follow-Up, and Relapse Prevention
    Setting Limits
    Self Monitoring of Food and Activity (Appendix 3.I)
    Cue Elimination
    Stimulus Control
    Goal Setting; Short-Term, Long-Term, and Weekly (Appendix 3.O and Appendix 3.P)
    Goal Assessment (Appendix 3.R)
    Behavioral Substitution or Replacement (Appendix 3.S)
    Relapse Prevention
    Applied Activities and Experiences (Appendices 3.U to 3.Z)
    Family Physical Activity and Fitness Education Sessions
    Pediatric Obesity and Exercise Performance
    Exercise Instruction in Interactive, Interdisciplinary Clinical Settings
    Lesson 1: Benefits of Exercise, Exercise safety, Warming-Up, Exercise Prescription, and Increasing Your Daily Activity — The MPEP-Step
    Lesson 2: Exercise Intensity and Pacing Skills (Metabolic Systems), Cooling Down After Exercise
    Lesson 3: Aerobic Exercise — Modified Field Sports, the Homework Rule
    Lesson 4: Muscular Strength and Endurance: “MPEP PUMP;” Strength Training Circuit; Creating Indoor Play Areas
    Lesson 5: Family Field Sports — Aerobic Volleyball; Creating Outdoor Play Areas
    Lesson 6: Flexibility, Flex Test I, and Stretch and Flex Class
    Lesson 7: Aerobic Exercise and Cardiopulmonary Endurance, Steady State — Monitoring Heart Rate and Aerobic Circuit
    Lesson 8: Exercise Prescriptions; The Fit Kit Walking Program
    Lesson 9: Review Muscular Strength and Endurance: Pull Your Own Weight Series
    Lesson 10: Park Day — Outdoor Play
    Nutrition Education Sessions
    References
    Appendix 1: Clinical Management Forms
    Appendix 2: Testing/Measurement Protocols
    Appendix 3: Sample Intervention Materials
    Index

    Biography

    Melinda S. Sothern, Stewart T. Gordon, T. Kristian von Almen

    “This is a clinically based approach for the treatment of pediatric obesity written for healthcare and research professionals by editors who have had at least two decades of experience in treating children and families with obesity. … The purpose is to educate healthcare and research professionals on the problems of childhood obesity and the varied approaches in its treatment. The mission of the book is to provide clinically appropriate, scientifically supported information on obesity. … The book meets the author’s objective as an easy-to-use clinical reference for healthcare professionals in pediatrics covering the entire range of issues in childhood obesity. … The audience consists of pediatric healthcare professionals in all areas of pediatrics dealing with families and children who are obese. … This is an excellent book by experienced authors in the field of childhood obesity detailing various approaches in the diagnosis and management of this condition. Particularly impressive are the section on medical aspects of treatment, clinical evaluation, behavioral counseling, surgery, and interactive group instruction. This is an important book that should be part of pediatrician’s library.”
    — Douglas Moodie, Ochsner Clinic Foundation, in Doody’s Review Service

    “This handbook focuses its attention on the most disturbing component of the obesity issue – the overweight child. … This text examines the subject of pediatric obesity in compete terms (medical, psychological, nutritional) in order to show the healthcare provider that child-patients are much different that adults and must be treated with a tempered hand. … the goal is to teach children to become conscious of the things they are eating and the affects food has on ambition, health, energy-levels and appearance. … is a clearly written textbook which presents a wealth of clinical data on all aspects of childhood obesity, with well-shaped chapters on the psychological and behavioral factors of obesity serving to demonstrate that each child-patient requires an individualized care-plan and extra patience. … Recommended to all clinicians who treat the pediatric patient and counsel parents on how to care for an obese child. Also recommended to Health Science libraries as well-rounded reference that covers both medical and psychological elements of obesity.”
    — John Aiello, in Electric Review

    “The purpose of this handbook is to provide background information, clinical examination tools, and available treatment approaches for medical professionals who are interested in combating the increasing prevalence of pediatric obesity. This book is relevant for pediatric physical therapists and physical therapist assistants. The material in the book is covered in a comprehensive manner. … The book is an excellent source for up-to-date information on the many aspects of pediatric obesity. The content is well supported with references to hundreds of current articles … the content is covered in sufficient detail for the book to be considered a comprehensive text on the subject. … In addition, the book provides 3 separate voluminous appendices covering 120 pages. These appendices include clinical management forms, checklists, fitness evaluation forms, testing protocols, resources, a table of food portions and units, and full meal plans. This reference is relevant to physical therapists and physical therapists assistants who are interested in the topic of pediatric obesity, and I would recommend its addition to their professional library.”
    — Ricardo A. Fernandez, physical therapist, AthletiCo, Chicago, in APTA, American Physical Therapy Association, Vol. 87, No. 3, March 2007

    “…an excellent book by experienced authors in the field of childhood obesity detailing various approaches in the diagnosis and management of this condition. Particularly impressive are the sections on medical aspects of treatment, clinical evaluation, behavioral counseling, surgery, and interactive group instruction. This is an important book that should be part of a pediatrician's library.”
    Doody’s Review Service

    The Trim Kids Program was recently accepted by the National Cancer Institute (NCI) of the National Institutes of Health as a Research Tested Intervention Program
    Program was recently accepted by the National Cancer Institute (NCI) of the National Institutes of Health as a Research Tested Intervention Program

    "… a clearly written textbook which presents a wealth of clinical data on all aspects of childhood obesity… Recommended to all clinicians who treat the pediatric patient and counsel parents on how to care for an obese child. Also recommended to Health Science libraries as a well-rounded reference that covers both medical and psychological elements of obesity."

    --The Electric Review