With childhood obesity a persistent problem, leaders of the nation's top children's hospitals recommend that primary care pediatricians help identify and treat four related medical conditions previously found in adults that may be overlooked.
The experts, including Dr. Elizabeth Estrada, director of the Pediatric Obesity Center at Connecticut Children's Medical Center, issued recommendations this month that call on pediatricians to screen for and treat lipid abnormalities, abnormal liver enzymes, hypertension, and polycystic ovary syndrome in children with obesity.
The recommendations, developed in collaboration with the Children's Hospital Association, include guidelines on when to involve specialists in the care of the child.
"In providing a core set of user-friendly consensus statements on screening and treatment plans, we are not only empowering the primary pediatrician to address diseases that are rapidly spreading among children with obesity, we hope to motivate families to address these serious health conditions with a provider (with) whom they've held a long-standing relationship," Estrada said.
The group cited recent studies indicating that about one-third of children in the U.S. are obese or overweight, putting them at higher risk for such conditions as hypertension, sleep apnea, diabetes and fatty liver disease.
While the number of children with those conditions has climbed, primary care pediatricians often are under-equipped to deal with those co-morbidities, instead referring patients to specialists. But such specialists are in short supply, the hospital leaders said, prompting the push for pediatricians to take on more responsibility.
Currently, there are no specific evaluation criteria for children with obesity who are at greater risk for certain medical conditions, nor are there guidelines on how pediatricians should proceed with abnormal laboratory results. Practice patterns vary greatly, depending in part on access to subspecialists, the hospital group said.
By issuing guidelines, the Children's Hospital Association hopes to "address the conditions at the first line of defense -- the primary care pediatrician," said association president and CEO Mark Wietecha.