But several obstacles
discourage pediatricians and other primary care physicians from taking a more
active role in managing childhood obesity. An expert panel identified these
barriers and explored strategies for overcoming them in a Roundtable Discussion
on “New Ways to Overcome Old Barriers: Engaging Pediatricians and Primary Care
Physicians in Obesity Prevention and Intervention” presented in the current
issue of Childhood Obesity, a journal published by
Ann Liebert, Inc. The article is available free online.
Sothern, PhD, Professor and Director, Section of Health Promotion,
Behavioral, and Community Health Sciences Department in the School of Public
Health at Louisiana State University Health Sciences Center (New Orleans, LA)
and Pennington Biomedical Research Center (Baton Rouge, LA) moderated the
Roundtable Discussion. Participants included Sonia Caprio, MD,
Yale University School of Medicine (New Haven, CT); Stephen
Daniels, MD, PhD, University of Colorado School of Medicine (Aurora);
Stewart Gordon, MD, Louisiana State University School of
Medicine (New Orleans, LA); and David Ludwig, MD, PhD, Harvard
Medical School and Children’s Hospital Boston (Massachusetts). The panelists
identified several key barriers, including inadequate reimbursement for
childhood obesity management and prevention; lack of office time to interact
with and educate patients; lack of financial resources to support patient/family
education and counseling; and a “toxic” culture that encourages poor nutrition,
overeating, and a sedentary lifestyle.
“Unless government and insurance
reimburses for primary care prevention and treatment of childhood obesity, it is
not going to happen in a comprehensive way,” said David Ludwig.
Melinda Sothern proposed the creation of “community hubs” in which primary care
offices and clinics form alliances with schools, recreation departments, or
community centers in the area and work together “to support efforts to identify,
organize, and implement” group programs for children who are overweight or
The panelists also discussed the need to include more information
about childhood obesity and proper nutrition in the educational experiences of
medical students and residents. To help overcome time limitations, primary care
physicians can encourage their nursing staff to talk to parents about the
significance of the measurements they are taking, such as weight and height,
laying the groundwork for the physician to reinforce those messages.
often, pediatricians “do not plot the BMI (body mass index) over time and do not
focus on the development of obesity,” says Stephen Daniels, emphasizing the
importance of identifying trends such as increasing BMI as a key step in
prevention and management of childhood obesity.
Obesity is a bimonthly journal, published in print and online, and
the journal of record for all aspects of communication on the broad spectrum of
issues and strategies related to weight management and obesity prevention in
children and adolescents. The Journal includes peer-reviewed articles
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roundtable discussions, profiles of successful programs and interventions, and
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