ResourceInstitute of Medicine Weight Gain Recommendations for Pregnancy
Click the PDF for the Institute of Medicine’s recommendations for gestational weight gain in patients with single and twin pregnancies.
Healthcare Providers
Healthy pregnancies
Obesity is passed on from one generation to the next, and health problems during pregnancy like high blood pressure, high glucose levels, and excessive weight gain can compromise not only the woman’s future health but also her baby’s. Primary care and obstetric providers, in particular, have a unique position that enables them to make a significant impact on both the health of pregnant patients who have obesity and their unborn children.
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The impact overweight and obesity can have on the health and well-being of expectant mothers is well-documented, but not all providers are prepared to address it. The American College of Obstetricians and Gynecologists recommends providing counseling and referral services to expectant parents with obesity, recognizing the increased risks they face for various health issues.
Additionally, the provider role extends beyond immediate concerns to a long-term impact. Educating pregnant patients about the risks of obesity and gestational weight gain not only contributes to a healthier pregnancy but also helps reduce the future risk of obesity for their unborn children. By providing comprehensive care, you are not only addressing current health challenges but also working towards a healthier future for both mothers and their children.
Infant and child nutrition
Healthcare providers like pediatricians, primary care physicians, and family practitioners are instrumental in preventing and treating obesity in children, especially when it comes to establishing good nutrition habits from their earliest days. From overfeeding infants to choosing sugar-sweetened beverages for toddlers, parents need guidance to help avoid the nutritional pitfalls that can ultimately contribute to their child’s risk of developing obesity and related complications.
Establishing healthy habits
As we know, healthy habits most easily take hold when established during the early, formative years of childhood. Even taste preference is established by the age of five, making this juncture a critical point for action. By offering counseling and compassionate guidance, healthcare providers can empower parents to make informed decisions about their children’s nutrition, laying the foundation for a healthier future.
Clinical assessment of childhood obesity
In its January 2023 clinical practice guidelines, the American Academy of Pediatrics emphasizes the importance of addressing overweight and obesity in children and adolescents. The primary goal is to reduce excess body weight and promote the development of healthy lifestyle habits and a supportive daily environment for long-term well-being.
According to the recommendations, primary care providers should start evaluating children for overweight and obesity from age 2, using BMI and BMI percentile as key indicators. These measurements enable providers to classify a child’s weight, estimate body fat mass, and offer tailored counseling on associated health risks and age-specific treatments.
Monitoring outcomes includes assessing cardiovascular and metabolic profiles, health behaviors, changes in the child’s environment, positive parenting practices, and behavioral change skills. Addressing these aspects early can prevent obesity-related comorbidities and enhance a child’s overall quality of life.
ResourceChildhood Obesity Assessment Guidelines
For additional insight regarding which patients should be assessed and who is considered high risk, click the PDF.
The role of home & family
A healthy home environment and supportive family are essential to both a child’s current well-being and their future health. Numerous studies have identified key factors surrounding the home that can contribute to childhood obesity, such as the presence of unhealthy foods, a scarcity of fruits and vegetables, and the ubiquitous nature of screens in homes and bedrooms.
Recognizing the pivotal role the home plays, it is crucial that healthcare providers be prepared to address its impact with their patients and their families. However, it is equally important to emphasize that the home environment can also serve as a powerful force in preventing childhood obesity. Collaborative efforts within families, where they come together to understand and implement healthy behaviors, can have a significant, positive impact. Encouraging activities such as cooking nutritious meals, fostering shared mealtimes, and promoting physical activity have all been shown to contribute to children maintaining a healthy weight and developing lifelong habits.
Resources for a healthier home
As a trusted provider, your expertise and guidance are integral in ensuring that families receive the support they need to create environments conducive to the well-being of the children you treat. Here are some resources to help support your patients in fostering healthier homes:
ResourceAssessing the home environment
Click the PDF for best practices in learning about a family and child’s health behaviors.
Medication and surgery
To achieve the most effective outcomes and prevent associated complications, healthcare providers must consider diverse treatment options for childhood obesity, including medication and surgery. Currently, there are four FDA-approved weight loss medications for adolescents aged 12 years and older, each carrying specific risks and benefits and all necessitating accompanying behavior and lifestyle counseling.
For adolescents with severe obesity class II with a comorbidity, or severe obesity class III, bariatric surgery has been deemed safe and effective, receiving endorsement from the American Academy of Pediatrics. Comparable in safety risk to minor surgeries like gallbladder surgery, it induces hormonal changes that regulate hunger, satiety, and energy balance. Bariatric surgery holds the potential to reverse serious comorbidities such as sleep apnea and diabetes, emphasizing its role as a viable option in the comprehensive management of childhood obesity.