Guidelines Issued on Managing Pediatric Obesity

By Amy Orciari Herman

Edited by Susan Sadoughi, MD, and Richard Saitz, MD, MPH, FACP, DFASAM

The Endocrine Society has updated its guidelines on evaluating, treating, and preventing obesity in childhood.

Among the recommendations, published in the Journal of Clinical Endocrinology & Metabolism:

• Children or adolescents with a BMI at or above the 85th percentile should be assessed for metabolic syndrome, diabetes, and other related conditions.

• Evaluation of pediatric obesity should not include fasting insulin measurement, as "it has no diagnostic value."

• Obese youth should undergo laboratory evaluations for obesity-related endocrine disorders only if their stature or growth rate is below the expected for age and pubertal stage.

• Children with extreme obesity (e.g., BMI ≥120% of the 95th percentile) before their fifth birthday should be tested for genetic obesity syndromes, such as Prader-Willi syndrome.

As in the prior guidelines, the group emphasizes family-centered lifestyle modification for both preventing and treating obesity.