Pediatricians' perceptions and practices regarding childhood obesity.

A 42-item Likert format questionnaire examining pediatricians' perceptions and practices concerning childhood obesity was distributed to a national random sample of 500 physicians. The overall response rate was 68%. The majority of pediatricians believed physicians are obligated to counsel parents of obese children regarding the health risks of obesity (83%), that normal weight is important to the health of children (67%), and that physicians should be role models by maintaining their normal weight (59%). However, 70% of these pediatricians believed designing programs and counseling children about weight loss was difficult, 22% felt competent in prescribing weight loss programs for children, and only 11% agreed that counseling children and parents on weight loss is professionally gratifying. At least one-half of the respondents recommended the following weight loss programs/techniques to their patients: (1) decreasing caloric consumption (84%), (2) seeing a dietitian/nutritionist (78%), (3) joining Weight Watchers (66%), (4) aerobic exercise (60%), and (5) behavior modification programs (55%). These pediatricians received most of their weight control information from medical journals (70%) and past experience (68%). We also assessed belief and attitudes concerning the effect of childhood obesity, the role obesity plays in selected diseases, and the etiology of childhood obesity.

Elementary school principals' perceptions of childhood obesity.

This survey assessed school principals' perceptions regarding childhood obesity and the schools' role in dealing with the problem. A randomly selected group of 300 school principals was obtained from the National Association of Elementary School Principals; 227 (76%) administrators returned the questionnaire. Fifty-one percent of the principals believed normal weight was important to child health. Although 35% believed schools were not doing enough to alleviate childhood obesity, responses suggested principals oppose schools becoming obesity treatment centers. They do not believe teachers or parents would support such programs. They perceived the school's role to be educational and referral in nature. However, they supported elimination of "junk food" machines (71%) and provision of low calorie lunches (60%). They believed school nurses play the most important role in treating childhood obesity at school.

School nurses' perceptions of childhood obesity.

A random sample of 250 nurses from the American School Health Association membership were sent a questionnaire concerning childhood obesity; 88% responded. Most (85%) believed normal weight was important to children's health and that school nurses should be role models by maintaining normal weight (77%). Most also believed counseling children and their parents about weight loss was difficult (71%) and that schools need to do more to alleviate childhood obesity (65%). At least 75% believed all schools should offer a comprehensive health curriculum with units on nutrition and weight control. Likewise, all schools should eliminate "junk food" machines and make special low-calorie lunches available. Only 25% felt competent to prescribe weight loss programs for children, and only 30% found counseling about weight loss professionally gratifying. One-fourth believed, that with proper guidance, children could lose significant amounts of weight or maintain that weight loss. The nurses believed in the importance of normal weight, but appeared skeptical of children's abilities to lose weight as well as their own abilities to provide children with guidance to do so. Finally, they perceived a need for schools to be more active and involved in dealing with childhood obesity.