Prevention of obesity in children should be the first line of treatment. This requires a broad-based public health program.
Developments in health and education services are required to provide more effective surveillance of overweight and obesity in early childhood, better identification of overweight and obese children, and greater and more effective support for families to prevent and treat obesity.
Paediatricians are encouraged to become advocates for the prevention of obesity by identifying and targeting influential specialists (e.g., health care professionals, nutritionists, and child development specialists) for education on obesity. They should also encourage, support, and protect breastfeeding, promote healthy eating habits, promote physical activity, and recommend limitation of television viewing in their day-to-day practice. In addition, recommending a good night’s sleep is of high importance given the emerging literature showing that short sleep duration is associated with overweight/obesity, particularly in children.
Interventions should target modifiable behaviours that might improve child health or development and should target behaviours that are important to the development and maintenance of a healthy weight (i.e., reduction in TV viewing, promotion of breastfeeding, reduction in soft drinks and sugar intake, increase in physical activity).
Parents and caregivers should be positive role models for children’s eating and physical behaviours. They should model healthful eating behaviours and make healthful food available to their children in an effort to lower the risk of obesity for their children. In this respect, insufficient knowledge about healthy nutrition, unhealthy eating behaviours and physical inactivity among parents can lead to poor eating and physical activity behaviours in their children. Treatment is therefore more likely to be effective if the family is the focus (not just the obese child), if the family is motivated to make the necessary lifestyle changes, if the treatment is of significant duration and if it focuses on modifying sedentary behaviour as well as diet.
However, obesity prevention will likely fail if the child’s environment is not addressed. For example, research suggests that reducing snack food advertising helps to prevent detrimental eating behaviour. The nutritional quality of foods and beverages served and sold in schools should also be improved. Children should be encouraged to reduce their consumption of soft drinks and other sugar-added beverages, to increase their level of physical activities, and to reduce their amount of television viewing. Macro-environmental changes that promote physical activity and play are urgently required if the paediatric obesity epidemic is to be addressed.
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