Obesity in Children (2015)

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    The CTFPHC released the “Recommendations for growth monitoring, and prevention and management of overweight and obesity in children and youth in primary care” in 2015.

    The task force recognizes that this guideline is currently out-of-date and has made a decision to place an update to this topic “on hold” as of December 2022. This pragmatic decision not to proceed on an update at this time was based on the following:

    • The evolving concept of obesity as a health issue (e.g., chronic disease or disorder versus risk factor)
    • A shift to patient-important health outcomes in obesity assessment rather than a primarily weight loss focus
    • Substantial changes in obesity management including psychological and pharmaceutical interventions
    • Available and upcoming comprehensive Canadian guidelines on obesity in children

    The task force acknowledges the importance of this topic to the health and wellbeing of young Canadians. We will continue to evaluate this topic for an update during our annual topic selection.

    Summary of recommendations for clinicians and policy-makers

    Recommendations

    The growth monitoring recommendations apply to all children and youth 0–17 years of age who present to primary care.

    • We recommend growth monitoring at all appropriate primary care visits using the 2014 WHO Growth Charts for Canada.(Strong recommendation; very low quality evidence)The prevention recommendations apply to all children and youth 0–17 years of age who have a healthy weight. They do not apply to children and youth with eating disorders, or who are underweight, overweight, or obese.
    • We recommend that primary care practitioners not routinely offer structured interventions aimed at preventing overweight and obesity in healthy weight children and youth.(Weak recommendation; very low quality evidence)The management recommendations apply to children and youth 2–17 years of age who are overweight or obese. Children and youth with health conditions where weight management is inappropriate are excluded.
      • For children and youth aged 2 to 17 years who are overweight or obese, we recommend that primary care practitioners offer or refer to structured behavioural interventions aimed at healthy weight management.
        (Weak recommendation; moderate quality evidence)
      • For children and youth aged 2 to 11 years who are overweight or obese, we recommend that primary care practitioners not offer Orlistat aimed at healthy weight management.
        (Strong recommendation; very low quality evidence)
      • For children and youth aged 12 to 17 years who are overweight or obese, we recommend that primary care practitioners not routinely offer Orlistat aimed at healthy weight management.
        (Weak recommendation; moderate quality evidence)
      • For children and youth aged 2 to 17 years who are overweight or obese, we recommend that primary care practitioners not routinely refer for surgical interventions.
        (Strong recommendation; very low quality evidence)

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