Clinical Practice Guideline for the Evaluation and Treatment of Children and Adolescents With Obesity

The current and long-term health of 14.4 million children and adolescents is affected by obesity,1,2 making it one of the most common pediatric chronic diseases.3–5 Long stigmatized as a reversible consequence of personal choices, obesity has complex genetic, physiologic, socioeconomic, and environmental contributors. As the environment has become increasingly obesogenic, access to evidence-based treatment has become even more crucial.

A significant milestone in the fight to counter misperceptions about obesity and its causes occurred in 1998, when the National Institutes of Health (NIH) designated obesity as a chronic disease.

This is the AAP’s first clinical practice guideline (CPG) outlining evidence-based evaluation and treatment of children and adolescents with overweight and obesity.

This guideline does not cover the prevention of obesity, which will be addressed in a forthcoming AAP policy statement.

Childhood obesity results from a multifactorial set of socioecological, environmental, and genetic influences that act on children and families. Individuals exposed to adversity can have alterations in immunologic, metabolic, and epigenetic processes that increase risk for obesity by altering energy regulation.17–19 These influences tend to be more prevalent among children who have experienced negative environmental and SDoHs, such as racism.

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