Recognition and management of childhood overweight and obesity by clinicians

Aim: (i) To determine the ability of general practitioners (GPs) and paediatricians to correctly identify children as overweight or obese by visual cues alone; (ii) to describe the current management practices of overweight and obese children by these practitioners; and (iii) to compare these with National Health and Medical Research Council (NHMRC) Clinical Practice Guidelines. Methods: Forty-four GPs and 29 paediatricians participated in the study. Respondents completed a questionnaire based on a series of body images, rating the size of the child as acceptable weight, overweight or obese and indicating the likelihood of carrying out a series of management options. Results: There was considerable variation in ability to rate images correctly with the total number of correct responses being 72% and 68%, respectively, for GPs and paediatricians. There were statistically significant differences in management between GPs and paediatricians in terms of conducting appropriate anthropometry and screening for co-morbidities, with paediatricians performing closer to the NHMRC Clinical Practice Guidelines. Conclusion: GPs and paediatricians have the opportunity to screen children for overweight and obesity during their everyday practice. Accurate determination of weight status cannot be performed by visualisation alone and all children should have height and weight measured and correctly interpreted. Some areas of current GP and paediatrician management of overweight and obese children fall short of the NHMRC clinical guidelines and areas for improvement are highlighted in this paper.