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Improving access and systems of care for evidence‐based childhood obesity treatment: Conference key findings and next steps

TLDR
To improve systems of care to advance implementation of the U.S. Preventive Services Task Force recommendations for childhood obesity treatment, clinicians offer/refer children with obesity to intensive, multicomponent behavioral interventions of >25 h over 6 to 12 months to improve weight status.
Abstract
Objective To improve systems of care to advance implementation of the U.S. Preventive Services Task Force recommendations for childhood obesity treatment (i.e., clinicians offer/refer children with obesity to intensive, multicomponent behavioral interventions of >25 h over 6 to 12 months to improve weight status) and to expand payment for these services. Methods In July 2015, 43 cross-sector stakeholders attended a conference supported by the Agency for Healthcare Research and Quality, American Academy of Pediatrics Institute for Healthy Childhood Weight, and The Obesity Society. Plenary sessions presenting scientific evidence and clinical and payment practices were interspersed with breakout sessions to identify consensus recommendations. Results Consensus recommendations for childhood obesity treatment included: family-based multicomponent behavioral therapy; integrated care model; and multidisciplinary care team. The use of evidence-based protocols, a well-trained healthcare team, medical oversight, and treatment at or above the minimum dose (e.g., >25 h) are critical components to ensure effective delivery of high-quality care and to achieve clinically meaningful weight loss. Approaches to secure reimbursement for evidence-based obesity treatment within payment models were recommended. Conclusions Continued cross-sector collaboration is crucial to ensure a unified approach to increase payment and access for childhood obesity treatment and to scale up training to ensure quality of care.

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Proportion and number of cancer cases and deaths attributable to potentially modifiable risk factors in the United States

TL;DR: These results may underestimate the overall proportion of cancers attributable to modifiable factors, because the impact of all established risk factors could not be quantified, and many likely modifiable risk factors are not yet firmly established as causal.
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Cardiovascular Risk Reduction in High-Risk Pediatric Patients: A Scientific Statement From the American Heart Association.

TL;DR: This scientific statement presents considerations for clinical management regarding the assessment and risk reduction of select pediatric populations at high risk for premature cardiovascular disease, including acquired arteriosclerosis or atherosclerosis.
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Evaluation and Management of Youth-Onset Type 2 Diabetes: A Position Statement by the American Diabetes Association

TL;DR: These guidelines summarize available data specific to the comprehensive care of youth with type 2 diabetes and describe the relationship between β-cell function and insulin sensitivity and the disposition index, which essentially expresses the amount of insulin being secreted relative to the degree of insulin resistance.
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Behavioral interventions for obesity in children and adults: Evidence base, novel approaches, and translation into practice

TL;DR: Traditional behavioral weight loss strategies designed to change energy-balance behaviors (i.e., dietary and physical activity behaviors) and the contexts within which these interventions have typically been delivered are introduced.
Journal ArticleDOI

A Review of the Prevention and Medical Management of Childhood Obesity

TL;DR: The United States Prevention Services Task Force recommends children older than age 6 of years be screened for obesity and, if clinically indicated, be referred for moderate to high intensity comprehensive behavioral interventions.
References
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TL;DR: In this paper, the authors compared a lifestyle intervention with metformin to prevent or delay the development of Type 2 diabetes in nondiabetic individuals. And they found that the lifestyle intervention was significantly more effective than the medication.
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Expert Committee Recommendations Regarding the Prevention, Assessment, and Treatment of Child and Adolescent Overweight and Obesity: Summary Report

TL;DR: These recommendations recognize the importance of social and environmental change to reduce the obesity epidemic but also identify ways healthcare providers and health care systems can be part of broader efforts.
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Overweight, Obesity, and Depression A Systematic Review and Meta-analysis of Longitudinal Studies

TL;DR: A reciprocal link between depression and obesity was found to increase the risk of depression, most pronounced among Americans and for clinically diagnosed depression, in addition to depression being predictive of developing obesity.
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Childhood obesity: public-health crisis, common sense cure

TL;DR: In view of its rapid development in genetically stable populations, the childhood obesity epidemic can be primarily attributed to adverse environmental factors for which straightforward, if politically difficult, solutions exist.
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Health Consequences of Obesity in Youth: Childhood Predictors of Adult Disease

TL;DR: The adverse effects of obesity in children and adolescents are considered and areas for future research are outlined.
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