Management Of Childhood Obesity Research Articles

LIFESTYLE FACTORS AND RISK OF OBESITY AMONG THE SCHOOL CHILDREN IN KHULNA CITY

As childhood obesity is increasing in urban areas, this study was designed to explain the association of lifestyle-related factors with obesity among primary school children in the Khulna City of Bangladesh. Data were collected from 257 purposively selected mothers of primary school children. A semi-structured interview schedule was used for data collection during February and March 2019. Findings indicated that a significant proportion of the teenagers were obese (44%). Results from regression analysis revealed that children having health problems, frequency of meals taken per day, and time spent in outdoor games have a significant association (p < 0.05) with childhood obesity. Moreover, children having health problems (AOR = 4.941; 95% CI: 2.273-10.745; p < 0.001), taking meals more than three times in a day (AOR = 24.534; 95% CI: 10.024-60.046; p < 0.001), and spending less time in outdoor games (AOR = 2.736; 95% CI: 1.242-6.028; p < 0.05)) were more likely to be obese. The study suggests that parents should motivate their children to adopt a healthy lifestyle. In addition, adequate playgrounds for children can help to prevent obesity and should be prioritized in the management of childhood obesity.

Dose-Response Relationship of a Blended In-Person and Online Family-Based Childhood Obesity Management Program: Secondary Analysis of a Behavior Intervention.

BackgroundThe Early Intervention Program (EIP) was a 10-week, blended, in-person and online lifestyle intervention for families with children who were off the healthy weight trajectory. The engagement pattern and the dose response of EIP have not been examined.ObjectiveThe aims of this paper are to examine families’ engagement patterns with the EIP and to evaluate the dose-response relationship between EIP engagement patterns and physical activity and healthy eating–related outcomes at 10 weeks.MethodsFamilies with children (8-12 years old) who are off the healthy weight trajectory (child BMI ≥85th percentile for age and sex) were recruited. Pre- and postintervention questionnaires assessed child lifestyle behaviors, parental support behaviors, family lifestyle habits, as well as parental physical activity and healthy-eating identity. Hierarchical cluster analysis of both in-person and online components was used to classify engagement patterns. Regression analysis assessed differences in outcomes by engagement groups.ResultsTwo distinct clusters of engagement groups were identified (N=66), which were in-person (IP; n=40, 61%) and in-person + online (IP+; n=26, 39%) engagement. Relative to the IP group at week 10, IP+ showed a greater child moderate-to-vigorous physical activity level (1.53, SD 0.56; P=.008), child physical activity confidence (1.04, SD 0.37; P=.007), parental support for child physical activity (5.54, SD 2.57; P=.04) and healthy eating (2.43, SD 1.16; P=.04), family habits for physical activity (3.02, SD 1.50; P=.049) and healthy eating (3.95, SD 1.84; P=.04), and parental identity for physical activity (2.82, SD 1.19; P=.02).ConclusionsThe online EIP portal complemented the in-person sessions. Additional engagement with the portal was associated with greater improvements in child physical activity and parental support behaviors, habits, and identity for physical activity.

Impact of Covid-19 Pandemic on the Effectiveness of Outpatient Counseling in Childhood Obesity Management.

The Covid-19 pandemic drastically modified social life and lifestyle, in particular, among children and adolescents, promoting sedentary behaviors and unhealthy eating habits. The aims of this study were to assess the rate and the factors associated with outpatient drop-out in childhood obesity management, and to evaluate how the Covid-19 pandemic influenced weight status and lifestyle of children and adolescents with obesity. One hundred and forty-five children and adolescents with obesity were identified, including 80 subjects evaluated before the Covid-19 pandemic (group A) and 65 subjects in the period straddling the Covid-19 pandemic (group B). Anamnestic (family history of obesity, dietary habits, physical activity, screen time), socio-cultural (economic status, employment and schooling of parents, household composition, place of living) and clinical (weight, height, BMI, waist circumference) data were retrospectively analyzed for each subject in both groups at baseline (V0) and 12-months (V1) at in-person assessment. Glycemic and lipid profiles were assessed at V0. Drop-out rate did not differ significantly between the two groups. BMI SDS at V0 (OR=2.52; p=0.004), female sex (OR=0.41; p=0.035), and the presence of a single parent in the household (OR=5.74; p=0.033) significantly influenced drop-out in both groups. Weight loss between V0 and V1 was significantly greater among group A patients compared to group B (p=0.031). In group B, hours spent in physical activity significantly decreased from V0 to V1, being significantly lower than group A at V1; on the contrary, screen time significantly increased in the same period. The consumption of sugary drinks and snacks was significantly greater in group B than group A at V1. Our study documented that the Covid-19 pandemic, although not affecting the drop-out rate of obese children in a follow-up program, negatively influenced lifestyle and reduced the effectiveness of outpatient counseling in childhood obesity treatment.

ENTREN-F family-system based intervention for managing childhood obesity: Study protocol for a randomized controlled trial at primary care

BackgroundPediatric obesity is a primary public health concern, and designing effective programs for managing it is of the utmost importance. The objective of this study was to describe the protocol study of a three-arm, parallel, randomized controlled trial aimed at assessing the efficacy of a family-system-based intervention (“ENTREN-F” program) for managing childhood obesity, compared to the “ENTREN” program (no “F” - without specific family-system-based workshop) and a control group (behavioral monitoring). Methods/designThe ENTREN-F program was a multicomponent family-system-based intervention carried out by a multidisciplinary team in the primary health care setting. The program targeted children between 8 and 12 years with overweight and obesity (P ≥ 85th). Parents were actively involved in the process. The contents were designed using the Cognitive Behavioral Therapy (CBT) principles. The program comprised individual behavioral monitoring, a healthy habits workshop for children and their parents, a CBT workshop for children, and a family-system-based workshop for parents, enhancing parental management skills plus family functioning. The trial’s primary outcomes included changes in child body mass index (BMI) z-scores, child’s psychological well-being, and family functioning over six months. Secondary outcomes included changes in eating behavior, physical activity, self-esteem, parental distress, parental feeding practices, and parental modeling. DiscussionTo our knowledge, this is one of the few randomized controlled trials to assess the efficacy of a multicomponent program that considers health from a comprehensive perspective, trying to improve children’s psychological well-being and family functioning besides weight loss. This study, therefore, addresses a gap in the literature. If found to be efficacious, it suggests a new potential health service for translation into National Primary Health Care services in Spain, one of the ten countries with the highest prevalence of obesity in Europe.

Parents’ Perception of Child Weight Status, Risk Factors and Health Concern of Childhood Obesity: A Systematic Review

The increased prevalence of childhood obesity is becoming a public health concern as it is related to numerous health implications. Parental perception of child’s weight status is an important factor for reducing childhood obesity burden. Parental perception of the risk factors and health outcomes of obesity are important in prevention and management of childhood obesity. However, previous reviews focused mainly on parental perceptions about healthy behaviors to reduce the burden of childhood obesity. Thus, this systematic review was carried out to investigate parental perceptions of their child weight status as well as risk factors and health concern of childhood obesity. A systematic review was conducted and was reported in accordance with PRISMA statement on studies between 2012 and 2017 through a variety of database like CINAHL, PubMed, Science Direct, Scopus and Cochrane Library. However, out of 2,334 articles identified, only 35 studies were included, which originate mostly from high-income countries. The results revealed that parents’ misperception rate of their children’s weight varies from 9.6% to 90%, while parents perceptive that only genetic factors, non-vegetable-consumption or low physical activity and environmental factors are the key risk factors of childhood obesity. Hence, parents’ of obese children estimate their children to be at risk at having hypertension, heart disease, depression, and diabetes. In conclusion, parents have difficulty in correctly perceiving the obesity status of their children. Health care workers should be aware of the parents’ wrong perception of their children’s weight status. The result of this review may be used to develop an effective intervention programs aimed at reducing the burden of childhood obesity which focus on the parental perception of the risk factors contributing to childhood obesity.

Management of Obesity in Ghanaian Children: Voices of Health-workers and Parents

Obesity has been described by the World Bank as a “ticking time bomb” which has significant potential devastating economic and health effects, for the poor, and low-and-middle-income country dwellers. However, obesity is thought of as a challenge only among the rich, urban, and high-income country inhabitants. This study was conducted in Ghana to gain in-depth understanding of the determinants and management of obesity in children among healthworkers and parents. A qualitative case-study in design, data were collected with an in-depth interview guide from five doctors, seven nurses and eighteen parents purposively selected from the paediatric department of the 37 Military Hospital. Recorded interviews were transcribed, coded manually, and analyzed using the principles of Grounded Theory. Obesity in children is on the ascendancy with inadequate management. Determinants are both familial and environmental with detrimental health and psychological consequences. Some healthcare providers need to be trained in the assessment, diagnosis, proper interpretation, and management of the condition. There is also the need for mass education of the public especially parents, by relevant stakeholders to reduce the incidence of obesity in children and its attendant problems in Ghana.

Family-reported barriers and predictors of short-term attendance in a multidisciplinary intervention for managing childhood obesity: A psycho-family-system based randomised controlled trial (ENTREN-F).

This study was aimed to examine patient enrolment in the pre-intervention stage, family-reported barriers, attendance rates and underlying predictors of short-term attendance in a family-system-based randomised controlled trial for managing childhood obesity in children aged 8-12-years-old (ENTREN-F). Psychosocial and anthropometric measures were collected through primary health referral. The data were used for descriptive analyses of sample characteristics and linear regression analyses. Low enrolment rates and several family-reported barriers were observed in the pre-intervention stage. Logistical barriers were the most frequent family-reported reason for attrition in the different stages of the study. Having a first face-to-face orientation session with the families and the use of motivational interviewing helped to improve adherence in the initial phases of the study. After 6months of intervention, family based treatments (FBTs) under consideration achieve greater adherence compared with the standard intervention. Moreover, family involvement was a predictor of success for better treatment adherence rates. By contrast, participants who attended a brief standard intervention, mothers with primary education, greater body mass index, higher levels of depressive symptomatology and more critical comments towards their children, children with higher weight status and lower levels of self-reported depressive symptoms at baseline attended interventions less frequently. In future programmes a comprehensive screening of modifiable factors related to family and their setting characteristics is paramount prior to intervention, identifying key barriers related to drop-out, especially in the case of less-advantaged families.

Fifteen-minute consultation: The child with obesity

Obesity is common among children and young people, with potential for significant clinical consequences. The physical and psychological comorbidities associated with childhood obesity persist into adult life, but many children...

Heterozygous Genetic Variants in Autosomal Recessive Genes of the Leptin-Melanocortin Signalling Pathway Are Associated With the Development of Childhood Obesity.

Monogenic obesity is a severe, genetically determined disorder that affects up to 1/1000 newborns. Recent reports on potential new therapeutics and innovative clinical approaches have highlighted the need for early identification of individuals with rare genetic variants that can alter the functioning of the leptin-melanocortin signalling pathway, in order to speed up clinical intervention and reduce the risk of chronic complications. Therefore, next-generation DNA sequencing of central genes in the leptin-melanocortin pathway was performed in 1508 children and adolescents with and without obesity, aged 2-19 years. The recruited cohort comprised approximately 5% of the national paediatric population with obesity. The model-estimated effect size of rare variants in the leptin-melanocortin signalling pathway on longitudinal weight gain between carriers and non-carriers was derived. In total, 21 (1.4%) participants had known disease-causing heterozygous variants (DCVs) in the genes under investigation, and 62 (4.1%) participants were carriers of rare variants of unknown clinical significance (VUS). The estimated frequency of potential genetic variants associated with obesity (including rare VUS) ranged between 1/150 (VUS and DCV) and 1/850 (DCV) and differed significantly between participants with and without obesity. On average, the variants identified would result in approximately 7.6 kg (7.0-12.9 kg at the 95th percentile of body weight) (girls) and 8.4 kg (8.2-14.4 kg) (boys) of additional weight gain in carriers at age 18 years compared with subjects without obesity. In conclusion, children with a genetic predisposition to obesity can be promptly identified and may account for more than 6% of obesity cases. Early identification of genetic variants in the LEPR, PCSK1, POMC, MC3R and MC4R genes could reduce the societal burden and improve the clinical management of early severe childhood obesity and its implementation should be further investigated.

Perceptions and Practices of Oral Health Care Professionals in Preventing and Managing Childhood Obesity.

In this study, we aimed to explore the perceptions of oral health care professionals (OHCPs) on childhood overweight and obesity screening and management in oral health settings in the Greater Sydney region in New South Wales, Australia. OHCPs involved in the Healthy Smiles Healthy Kids (HSHK) birth cohort study were purposively selected for this nested qualitative study. A sample of 15 OHCPs completed the face-to-face interviews, and thematic analysis was undertaken to identify and analyse the contextual patterns and themes. Three major themes emerged: (1) obesity prevention and management in dental practice; (2) barriers and enablers to obesity prevention and management in dental settings; and (3) the role of oral health professionals in promoting healthy weight status. This study found that OHCPs are well-positioned and supportive in undertaking obesity screening and management in their routine clinical practice. However, their practices are limited due to barriers such as time constraints, limited knowledge, and limited referral pathways. Strategies including capacity building of OHCPs, development of appropriate training programs and resources, and identification of a clear specialist referral pathway are needed to address the current barriers. This study provides an insight into opportunities for the oral health workforce in promoting healthy weight status among children.

Treatment of Acquired Hypothalamic Obesity: Now and the Future.

The hypothalamus is the centre of neuroendocrine regulation of energy homeostasis and appetite. Maldevelopment of, or damage to, the key hypothalamic nuclei disrupts the coordinated balance between energy intake and expenditure leading, to rapid and excessive weight gain. Hypothalamic obesity is compounded by a disruption of the hypothalamic-pituitary axis, sleep disruption, visual compromise, and neurological and vascular sequalae. Amongst suprasellar tumors, craniopharyngioma is the most common cause of acquired hypothalamic obesity, either directly or following surgical or radiotherapeutic intervention. At present, therapy is limited to strategies to manage obesity but with a modest and variable impact. Current approaches include optimizing pituitary hormone replacement, calorie restriction, increased energy expenditure through physical activity, behavioral interventions, pharmacotherapy and bariatric surgery. Current pharmacotherapeutic approaches include stimulants that increase energy consumption, anti-diabetic agents, hypothalamic–pituitary substitution therapy, octreotide, and methionine aminopeptidase 2 (MetAP2) inhibitors. Some pharmacological studies of hypothalamic obesity report weight loss or stabilization but reported intervention periods are short, and others report no effect. The impact of bariatric surgery on weight loss in hypothalamic obesity again is variable. Novel or combined approaches to manage hypothalamic obesity are thus required to achieve credible and sustained weight loss. Identifying etiological factors contributing hypothalamic obesity may lead to multi-faceted interventions targeting hyperphagia, insulin resistance, decreased energy expenditure, sleep disturbance, hypopituitarism and psychosocial morbidity. Placebo-controlled trials using current single, or combination therapies are required to determine the impact of therapeutic agents. A well-defined approach to defining the location of hypothalamic damage may support the use of future targeted therapies. Intranasal oxytocin is currently being investigated as an anorexogenic agent. Novel agents including those targeting pro-opimelanocortin-C and AgRP/NPY expressing neurons and the MC4 receptor may result in better outcomes. This article discusses the current challenges in the management of hypothalamic obesity in children and young people and future therapeutic approaches to increasing weight loss and quality of life in these patients.

Efficacy of Emerging Technologies to Manage Childhood Obesity.

Childhood obesity is a widespread medical condition and presents a formidable challenge for public health. Long-term treatment strategies and early prevention strategies are required because obese children are more likely to carry this condition into adulthood, increasing their risk of developing other major health disorders. The present review analyses various technological interventions available for childhood obesity prevention and treatment. It also examines whether machine learning and technological interventions can play vital roles in its management. Twenty-six studies were shortlisted for the review using various technological strategies and analysed regarding their efficacy. While most of the selected studies showed positive outcomes, there was a lack of studies using robots and artificial intelligence to manage obesity in children. The use of machine learning was observed in various studies, and the integration of social robots and other efficacious strategies may be effective for treating childhood obesity in the future.

Il modello di gestione del bambino sovrappeso e obeso in Regione Emilia-Romagna: primi risultati

Child and adolescent obesity is a complex, multifactorial but also largely preventable disease; as a consequence its management needs a multilevel and integrated approach to be successful. This article describes the Preventive Diagnostic Therapeutic Assistance Pathways (PPDTA) for children with overweight and obesity delivered by trained multidisciplinary teams in the Emilia-Romagna Region. The regional “Guidelines for early detection, assessment and treatment of childhood obesity” were launched in 2013 (DGR 783/2013) and in 2017 WHO/Europe mentioned them as good practice and Country example. Training in childhood obesity prevention and management was delivered for all the primary care paediatricians (PCPs) and the members of the multidisciplinary teams. The PPDTA is based on three progressive levels: Level 1: PCPs. Level 2: a multidisciplinary team consisting of paediatricians, sports medicine doctors, exercise specialists, dieticians and psychologists experienced in paediatric obesity defines the clinical condition of children referred by the PCPs and runs the lifestyle change multi-component interventions. Level 3: is carried out by specialized clinicians in the hospital setting on a multidisciplinary basis for children with more severe and complicated obesity. In case of therapeutic failure, the PCP refers the child to the second-level multidisciplinary team. The second-level assessment and intervention are conducted at public health departments or at public health centres. During treatment, each team member uses the same tools, such as motivational interviewing for encouraging behaviour change. A standard evaluation framework is in place to assess the quality and effectiveness of the weight multidisciplinary management services, with three types of regional evaluation indicators: anthropometrics, lifestyle changes (eating habits, sedentary and physical activity) and equity. An improvement in weight status was observed in both children and adolescents with overweight and obesity. Interventions targeting at specific behaviours, such as increasing fruit and vegetable intake, habitually eating a balanced breakfast and reducing sedentary behaviour have been found effective as well.

Healthcare professionals\u2019 perceptions of childhood obesity in Iquitos, Peru: a qualitative study

BackgroundChildhood obesity is an urgent worldwide concern associated with increased morbidity in adulthood. Healthcare professionals (HCPs) are well placed to influence childhood obesity trends and implement interventions. English-language studies regarding HCPs’ perceptions of childhood obesity are limited to high-income countries. Peru is an upper-middle-income country with regional disparities in childhood obesity prevalence. This qualitative study aims to explore HCPs’ perceptions of childhood obesity in Iquitos, Peru, where prevalence is relatively low.MethodsTwenty-one HCPs with child healthcare experience were purposively recruited from two primary healthcare centres. Semi-structured, individual interviews were conducted with a translator and audio recorded. Transcribed data were analysed using thematic analysis.ResultsEight themes were identified and divided into four categories: (1) HCPs’ perceptions and attitudes towards childhood obesity (level of concern regarding childhood obesity, perceived consequences of childhood obesity); (2) Factors which HCPs perceive to be important in the development of childhood obesity (parental factors, contextual factors); (3) HCPs’ perceptions of their role in childhood obesity prevention and management (educating parents about childhood obesity, regular monitoring of child growth); and (4) Barriers and facilitators in childhood obesity prevention and management (in healthcare, in schools).ConclusionsHCPs had a low level of concern regarding childhood obesity in Iquitos and prioritised undernutrition. Parental factors were perceived to be the most influential in the development of childhood obesity. HCPs perceived themselves to have minimal influence due to prevailing positive views of excess weight and difficulties engaging parents. Educating parents about childhood obesity was felt to be essential to prevention and management although regular monitoring of child growth and home healthcare visits were viewed as useful additional measures. This study can help to inform the development of targeted public health strategies which are sensitive to local contexts and could prevent the upward childhood obesity trends evident elsewhere in Peru.

Burden of Early Life Obesity and Its Relationship with Protein Intake in Infancy: The Middle East Expert Consensus.

Adequate nutrition in early life is proposed to shape a child’s future health by launching the growth trajectory in the proper direction, which helps to avoid negative metabolic programming effects. Protein intake during infancy and early childhood is of great importance, as it plays a key role in infant metabolic programming and the future risk of obesity. Breastfeeding provides the best nutrition in early life, with many benefits tailored for the baby, including the appropriate quantity and quality of proteins. Considering the high prevalence of childhood, and subsequent adult, obesity in the region, a virtual Middle East expert consensus meeting was held to discuss an effective approach for managing childhood obesity. Leading pediatric experts from Bahrain, Egypt, Kuwait, Oman, Qatar, Saudi Arabia, and the United Arab Emirates participated in the meeting. The experts discussed, debated, and agreed on certain directions, including the importance of educating parents, endorsing breastfeeding, and ensuring optimum quantity and quality intake of proteins in early life. This expert consensus may serve as the starting point for healthcare professionals in the region who are interested in shaping a healthy future for the generations to come.

Obesity and overweight in Children below 5 years of age: Environmental, Behavioural and Social Factors and Their Active Use in Prevention and Management

Introduction: Early childhood is a critical time for obesity prevention. Children are developing taste preferences, learning to walk and play. They eagerly mimick both the healthy and unhealthy behavior of their parents, siblings and caregivers. Obesity during early childhood is a major health concern of the developed world and is steadily affecting many low- and middle-income countries, particularly in urban settings. Unfortunately, overweight, and obese children often stay obese into adulthood and more likely to develop many non-communicable diseases at a younger age. Important environmental and socioeconomic factors play a significant role in the initiation and progression of early childhood obesity. In this minireview, we try to shed light on the published data exploring various relevant issues, including possible etiologic factors in this target population at risk (children below 5 years) that may enable the initiation of early and effective policy and tactics for the prevention and management of this problem, particularly in high-risk communities.
 Methods: We examined the English language literature (Pubmed, Google scholar, and Cochrane library ) on the environmental and socioeconomic factors that appeared to be important in the pathogenesis of early obesity in children for the past 20 years. Inclusion criteria were obesity and overweight in young children below 5 years of age. 
 Results: Education, income, and urbanization, food environments and increased energy intake through consumption of fatty foods and a high sugar diet as well as parental effects through conveying their behaviors, attitudes, and feeding styles to their children appear to be among the most important factors that contribute to the initiation and progression of obesity in young children. Overfeeding preterms and small for gestational age infants, using artificial milk formula, and early addition of solid foods play a considerable share in inducing early obesity. In addition, lack of health education to parents and children, poor health care, and scarcity of access to physical activity are important risk factors in poor populations.
 Conclusions: Many important social and environmental factors can actively contribute to the production and progression of early childhood obesity. These factors differ considerably among different populations. Understanding these factors is essential for appropriate and early prevention as well as management of early childhood obesity, especially in high risk communities.

Obesity is an important paediatric problem that paediatricians and endocrinologists should address together

The increasing incidence of obesity in children and adolescents with its negative health consequences is one of the global problems of paediatrics and paediatric endocrinology. Approaches to the management of obese children are being developed and scientific and practical programmes for prevention and treatment are being established. Correctly assessing the risks of obesity in the long term and knowing how to influence them can help to reduce these risks. The primary care physician's priority is to make a diagnosis of overweight and obesity in children and to determine appropriate screening and treatment according to current clinical guidelines and known scientific evidence. The aim of this review is to briefly describe the risk factors, current epidemiological features of obesity and to provide a primary screening plan for children with exogenous obesity to assist the practicing paediatrician and paediatric endocrinologist.

Newer treatment options for childhood obesity management

Newer treatment options for childhood obesity management

736 Current Management Strategies, Perceptions, and Attitudes of the Paediatricians on Childhood Obesity: An Experience from the Middle East

Abstract Background Childhood obesity is a public health concern that in expanding globally. Of those aged between 5-19 years in Oman, 32% were found to be overweight in 2016. Method An electronic survey was distributed to in-training and post residency paediatricians in Oman. Results A total of 69 responses met the inclusion criteria and were analysed. 50% of participants were less than 30 years-old (53.6% female). 70% were in training residency (R1, R2 24.6%, R3, R4 36.2%,) and 30% were post residency. 72% had their training in Oman. About half of participants measure child’s weight and Height, however, only 24.4% document BMI and compare with previous records. 75% regularly obtain family history of obesity and related conditions along with dietary intake. More than half of participants were not confident on discussing weight and related complication with the child, but 62.3 % were confident in discussing it with the parents. 50% were confident in initiating treatment for childhood obesity and providing dietary advice. Attitudes towards exposure to childhood obesity and management varied and overall excellent exposure accounted for less than one third of responses (Medical school 21.7%, Residency 26.1%, 27.5%). In general, only 20.6% believe they are confident in managing childhood obesity and only 29% attended seminar or training on childhood obesity. 93% believe there is a need for a more focused training on childhood obesity prevention and management. Conclusions Great efforts need to be targeted towards strengthening Paediatricians’ confidence in childhood obesity prevention and management via in residency-training and continuous professional development.

Management of Obesity and Its Complications in Children and Adolescents.

Pediatric overweight/obesity has assumed epidemic proportions in India. It is associated with several significant complications and tracks into adulthood. The mainstay of management is a holistic lifestyle modification that must be adopted by the family as a whole. It involves dietary changes, regular physical activity, and behavioral changes that favor a healthy way of life. Regular follow-up, and attention to keeping up the motivation of the child and family achieves good results. In the present paper, a stepwise approach to prevention and management of childhood obesity is presented along with the recommendations for screening and management of associated complications and the role of pharmacotherapy and bariatric surgery.