Pediatric Obesity Treatment in Children With Neurodevelopmental Disabilities: A Case Series and Review of the Literature.

Obesity can affect any child, but it occurs disproportionately in children with developmental disabilities. Treatment efforts, however, have focused primarily on nondisabled children, and more research is needed to determine how current approaches can be modified for youth with neurodevelopmental disabilities. This article briefly reviews what is currently known about obesity treatment in these children and presents a case series describing methods employed by a family-based, multidisciplinary weight management program in the treatment of obesity. Lessons learned from clinical experience are also discussed, with implications for collaborating with families of children with disabilities in treatment, establishing healthy routines and schedules, setting the pace of treatment progression, and minimizing disruptions in the behavior change process. Though there are no expert recommendations specifically tailored to obesity treatment in children with neurodevelopmental disabilities, existing clinical programs such as the one described here can be adapted to better meet the needs of this underserved population. Further research is warranted to determine the most effective methods for addressing obesity in these children, as has been specified as a national health priority.

Motivational interviewing in a family-based pediatric obesity program: a case study.

Motivational Interviewing (MI) is an effective method for clinicians to guide and support individuals who wish to make complex health behavior changes; however, little research is available to support its use in the treatment of obesity, particularly in family based therapy and multidisciplinary team settings. The objective of this case report is to demonstrate the application of MI within a family based, multidisciplinary treatment program, and provide examples of MI in obesity treatment. We report a case study on the use of MI with behavioral therapy in a pediatric, family based, multidisciplinary weight management program (Brenner FIT Program). Tina, a 14-year-old White female, and her mother participated in the Brenner FIT Program where we successfully integrated MI into her obesity treatment. Further work is needed in the application of MI to diverse care teams to determine frequency of training required for effective use of MI in obesity treatment, its limitations, and its feasibility in community-based programs.

Multidisciplinary treatment of pediatric obesity: nutrition evaluation and management.

Assessment and treatment methods for pediatric obesity are rapidly evolving. Thought to be caused by an imbalance of caloric intake and expenditure, obesity requires a comprehensive evaluation of patient, familial, environmental, genetic, and cultural characteristics so clinicians can design successful interventions. Quantitative nutrition assessment of caloric intake is difficult and time consuming and should be used only in isolated settings, such as in the research setting, or if initial approaches to management have been unsuccessful. As an alternative, providers should identify dietary patterns or behaviors that have been linked to obesity and are promising targets for change. Clinicians should tailor interventions by considering patient and family motivation and readiness to change. Current guidelines recommend stepwise increases in treatment plans, and multidisciplinary treatment teams are recommended for patients who require intense intervention. Providers involved at the multidisciplinary level must incorporate their area of expertise into that of the team to develop a comprehensive management plan. This article reviews current recommendations for the evaluation and treatment of pediatric obesity with a focus on nutrition evaluation as part of a multidisciplinary team.