For years, parents, doctors and educators heard little but criticism, judgment and conflicting advice on childhood obesity.

But now experts can offer hope: medical research that shows focused treatment can help kids slim down.

An independent panel of experts has announced that obese children between 6 and 18 years should be steered to weight management programs that provide more than 25 hours of intensive counseling on diet, exercise and behavioral change over six months.

The recommendation, based on a rigorous review of the scientific evidence, comes from the U.S. Preventive Services Task Force, the highly regarded federal panel that recently ignited controversy with its advice that not all women in their 40s need annual mammograms.

“Our recommendation is not to say this is easy,” Dr. Ned Calonge, who as chairman of the task force was dissatisfied with the lack of evidence on treatments when the panel last reviewed the issue in 2005, said. “This really takes dedicated work and it takes a comprehensive program in order for us to get these benefits.”

That won’t surprise South Tampa mother Arlene Asgard, whose 11-year-old daughter, Tori, has struggled with her weight. To fend off a bigger problem down the road, they recently participated
in the Why Weight? program at St. Joseph’s Children’s Hospital.

For six weeks, both mother and daughter attended the weekly two-hour sessions that combined diet and nutrition instruction with physical activity. They left the program resolved to make lasting lifestyle changes.

BEHAVIORAL THERAPY FOR OBESITY

The task force’s experts in primary care and preventive medicine reviewed 20 studies on childhood obesity treatment. Most involved the behavioral intervention therapy now recommended. Seven studies added drug treatment to behavioral therapies for older children.

The report, published today in Pediatrics, the journal of the American Academy of Pediatrics, is geared to obese children, or those with a body mass index at or above the 95th percentile for age and gender. Overweight children, or those between the 85th and 95th percentiles, possibly could benefit, but there wasn’t enough evidence for the task force to include them in the recommendation.

The report said the results still were reason for hope in fighting an epidemic that worries health officials since obese children often become obese adults.

The recommendation should also guide pediatricians to refer patients to programs, rather than trying to handle weight-loss issues during brief checkups.

MAKE THAT CHANGE

Clinicians often tell parents “your child is overweight, you need to make these changes, and maybe give them a handout on nutrition,” said Jana Butler, manager of community health and weight management at St. Joseph’s Hospital. “Now it’s taking it a step further and saying, ‘Your child is really in a risk category for their weight and it’s time for a referral to a dietitian or to a program.’?”

Parents may worry about a possible stigma attached to seeking weight-loss help, but experts say they can help children deal with bullying and confidence issues.

The new recommendation isn’t going to solve the obesity epidemic, the task force chairman acknowledged. But neither will faulting parents and children for becoming overweight, without offering them solutions.

TIPS ON TREATING CHILDHOOD OBESITY

• Involve the family. If everyone’s exercising and eating healthy together, the child with a weight problem is more likely to be successful addressing it.
• Parents should lead by example; just telling a child to eat right and exercise isn’t enough.
• Involve the child in meal-planning and preparation. And remember that healthy lifestyle choices should be fun, not a chore.