Abstract
The prevalence of pediatric obesity has increased significantly, and the greatest increase in prevalence has occurred among the heaviest children. Severe pediatric obesity is associated with higher rates of medical and psychosocial morbidity than is milder obesity. Although the efficacy of family-based behavioral weight control programs in the treatment of moderate pediatric obesity is well established, there is little information on the treatment of severe obesity. We believe that family-based cognitive behavioral interventions, which focus on increasing healthy eating behaviors and physical activity and decreasing unhealthy eating and sedentary behaviors, are critical for these children. Treatment adaptations that address inappropriate eating among children, peer teasing, and poor body image also are useful in managing this high-risk population.
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