Abstract

BackgroundSevere obesity (SO) in Canadian children remains poorly understood. However, based on international data, the prevalence of SO appears to be increasing and is associated with a number of psychosocial, bio-mechanical, and cardiometabolic health risks. The purpose of our national Team to Address Bariatric Care in Canadian Children (Team ABC3) is to develop and lead a series of inter-related studies to enhance the understanding and management of SO in Canadian children and adolescents (0–18 years).Methods/designFrom 2015 to 2019, Team ABC3 will conduct a series of projects at the regional, provincial, and national levels using multiple methods and study designs to respond to key knowledge gaps by (i) generating evidence on the prevalence of SO and its impact on health services utilization in children using existing Canadian data sources from primary care settings, (ii) exploring contemporary definitions of SO that link with health outcomes, (iii) comparing and contrasting health risks across the continuum of SO, (iv) understanding potential barriers to and facilitators of treatment success in children with SO, and (v) examining innovative lifestyle and behavioral interventions designed to successfully manage SO in children and their families. Furthermore, to examine the impact of innovative interventions on the management SO, we will (vi) evaluate whether adding a health coach, who provides support via text, email, and/or phone, improves children’s ability to adhere to a web-based weight management program and (vii) test the feasibility and impact of a community-based weight management program for pre-school children with SO and their parents that combines group-based parenting sessions with in-home visits.DiscussionOur research aligns with national priorities in obesity research, brings together leading scientists, clinicians, and stakeholders from across Canada, and will inform health services delivery throughout the country to provide the best care possible for children with SO and their families.

Highlights

  • Severe obesity (SO) in Canadian children remains poorly understood

  • In Canada, approximately one in three children is classified as either overweight or obese, but no national-level data are available to quantify the magnitude of severe obesity (SO ≥99th percentile of body mass index (BMI)) [1]

  • The Team to Address Bariatric Care in Canadian Children (Team ABC3) was designed to respond to key knowledge gaps by (i) generating evidence on the prevalence of SO and its impact on health services utilization in children using existing Canadian data sources from primary care settings, (ii) exploring contemporary definitions of SO that link with health outcomes, (iii) comparing and contrasting health risks across the continuum of SO, (iv) understanding potential barriers to and facilitators of treatment success in children with SO, and (v) examining innovative lifestyle and behavioral interventions designed to successfully manage SO in children and their families

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Summary

Introduction

Severe obesity (SO) in Canadian children remains poorly understood. based on international data, the prevalence of SO appears to be increasing and is associated with a number of psychosocial, bio-mechanical, and cardiometabolic health risks. In Canada, approximately one in three children is classified as either overweight or obese, but no national-level data are available to quantify the magnitude of severe obesity (SO ≥99th percentile of BMI) [1]. In the United States, data suggest that the total proportion of children with obesity might have plateaued [2,3,4], but boys and girls with obesity have become even more obese over the past 15 years. Many Canadian pediatric weight management clinics use BMI ≥99th percentile to define SO, based on either the Centers for Disease Control and Prevention [16] or the World Health Organization [17] criteria.

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