Journals club - Childhood obesity

Curriculum statement 8 Care of Children and Young People

Key trials

  • A review found that lack of breastfeeding, high early energy intake and high intake of sugar-sweetened beverages seem to be the main dietary factors contributing to childhood obesity development (Curr Opin Clin Nutr Metab Care 2007; 10: 336-41).
  • A longitudinal study has shown that even children who are overweight at two years have up to five times greater risk of being overweight at the age of 12, compared with those with normal weights (Pediatrics 2006; 118: e594-601).
  • Although increased exercise is recommended for obese and overweight children, many have increased joint pain and discomfort, which may limit their exercise abilities (Obes Rev 2009; May 12 PMID: 19460114).
  • A systematic review has shown that although preventive strategies can change behaviour, the case for screening to treat individual children for obesity is unproven (Arch Dis Child 2007; 92: 416-22).

Evidence base

  • Multifactorial interventions may help overweight and obese children to lose weight when the interventions are targeted at the family (Clin Evid (Online) 2007 May 1; 2007 pii: 0325).
  • A recent Cochrane review found that combined behavioural lifestyle interventions can produce a significant reduction in overweight children. Also, in obese adolescents, orlistat or sibutramine may be effective as an adjunct to lifestyle interventions (Cochrane Database Syst Rev 2009; (1): CD001872).
  • One article has outlined ways that healthcare providers and public health officials can encourage, monitor and advocate increased physical activity for children and teenagers in order to reduce childhood obesity (Pediatrics 2006; 117: 1,834-42). However, many GPs feel that they do not have the time or training to manage obesity in children.
  • The DoH's 'How Are The Kids' survey showed that 72 per cent of children are not doing 60 minutes of daily activity outside of school, 45 per cent watch TV before school and only 22 per cent do something active after an evening meal.


  • NICE published guidance on the prevention, identification, assessment and management of overweight and obesity in adults and children in 2006.
  • In January 2008, the DoH published Healthy Weight, Healthy Lives: A Cross-Government Strategy for England; £372 million has been made available to implement the strategy, to enable everyone to maintain a healthy weight.

Contributed by Dr Louise Newson, a GP in the West Midlands

Key points

  • Obesity in children is increasing
  • Television watching is strongly linked with obesity
  • Exercise needs to be encouraged in children
  • The DoH have launched the Change4life campaign

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