Routinely measuring body mass index (BMI) and counseling patients on healthy eating and activity are critically important ways that pediatricians and primary care providers can help prevent obesity. Prenatal providers can promote breastfeeding, stress the importance of staying at a healthy weight before and during pregnancy, and encourage pregnant women to quit smoking. All providers should work to avoid bias and discrimination against people who are overweight or obese.
Here is a summary of primary care and prenatal care obesity prevention recommendations, based on a review of expert guidance from the American Academy of Pediatrics, the American Medical Association, the Institute of Medicine, the Childhood Obesity Action Network, and others. For more detailed guidance on these recommendations and ideas for putting them into practice, explore the source list and the links to other resources.
Pediatricians and Pediatric Primary Care Providers
- Eating breakfast daily (1)
- Limiting restaurant eating, especially fast-food restaurants (1)
- Eating meals as a family (1)
- Limiting portion sizes (1)
Adult Medicine Physicians and Primary Care Providers
Talking to Patients about Obesity
Overweight and obese adults who report that their doctors have told them they are overweight are more likely to have accurate perceptions of their own weight, according to a U.S.-based survey. They are also more likely to be interested in losing weight, and to have tried losing weight. Yet a third of obese patients say their doctors did not tell them they were overweight.
- Counseling/coaching/behavioral interventions on diet/lifestyle change (4,6,9,11,12,13,14)
- Weight loss medication for appropriate individuals who have been unable to lose weight through conventional therapy and who have no contraindications (9,11,12,14)
- Bariatric surgery for patients with severe obesity unable to lose weight through conventional therapy and who have no contraindications (9,11,12,14)
Obstetricians and Pre/Postnatal Care Providers
Early Life Influences on Obesity
Numerous factors during early life can affect a child’s obesity risk later in life: Maternal smoking, weight gain, and blood sugar levels during pregnancy, as well as an infant’s weight gain rate, breastfeeding, and sleep habits. Learn more about early life influences on obesity.
Screen pregnant women for gestational diabetes (21)
Primary Care and Prenatal Care-Source List
1. Barlow SE. Expert committee recommendations regarding the prevention, assessment, and treatment of child and adolescent overweight and obesity: summary report. Pediatrics. 2007;120 Suppl 4:S164-92.
2. National Committee for Quality Assurance. HEDIS 2009 Summary Table of Measures, Product Lines and Changes.Washington, D.C.: National Committee for Quality Assurance; 2008.
3. White House Task Force on Childhood Obesity. Solving the Problem of Childhood Obesity within a Generation: White House Task Force on Childhood Obesity Report to the President. White House Task Force on Childhood Obesity; 2010.
4. Let’s Move. Healthcare Providers Take Action. Accessed February 2, 2012.
5. Koplan JP, Liverman CT, Kraak VI, eds. Preventing Childhood Obesity: Health in the Balance. Washington, D.C.: The National Academies Press; 2005.
6. U.S. Department of Health and Human Services. The Surgeon General’s Vision for a Healthy and Fit Nation 2010. Rockville: U.S. Department of Health and Human Services, Office of the Surgeon General; 2010.
7. Childhood Obesity Action Network. Expert Committee Recommendations on the Assessment, Prevention and Treatment of Child and Adolescent Overweight and Obesity; 2007.
8. America’s Health Insurance Plans. Facing the Challenge of Unhealthy Weight: Recommendations for the Health Care Community; 2008.
9. Centre for Public Health Excellence. Guidance on the prevention, identification, assessment and management of overweight and obesity in adults and children. London: National Institute for Health and Clinical Excellence; 2006.
10. The Obesity Society. Position Statement: Youth Weight Bias and Discrimination in Healthcare Settings. Silver Spring: The Obesity Society; 2010.
11. Klein S, Burke LE, Bray GA, et al. Clinical implications of obesity with specific focus on cardiovascular disease: a statement for professionals from the American Heart Association Council on Nutrition, Physical Activity, and Metabolism: endorsed by the American College of Cardiology Foundation. Circulation. 2004;110:2952-67.
12. American Medical Association. Assessment and Management of Adult Obesity: A Primer for Physicians. Atlanta:American Medical Association; 2003.
13. U.S. Preventive Services Task Force. 2003. Screening for Obesity in Adults. Accessed March 8, 2012.
14. Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults – The Evidence Report. National Institutes of Health. Obes Res. 1998;6 Suppl 2:51S-209S.
15. Guidelines for Perinatal Care. Washington, D.C.: American Academy of Pediatrics and the American College of Obstetricians and Gynecologists; 2007.
16. Rasmussen K, Yaktine A. Weight Gain During Pregnancy: Reexamining the Guidelines. Washington, D.C.: Food and Nutrition Board, Institute of Medicine, National Research Council; 2009.
17. American Medical Association. 2011. H-245.982. AMA Support for Breastfeeding.
18. Shealy K, Li R, Benton-Davis S, Grummer-Strawn L. The CDC Guide to Breastfeeding Interventions. Atlanta: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention; 2005.
19. U.S. Department of Health and Human Services. The Surgeon General’s Call to Action to Support Breastfeeding. Washington, D.C.: U.S. Department of Health and Human Services, Office of the Surgeon General; 2011.
20. Smoking cessation during pregnancy. Committee Opinion No. 471. American College of Obstetricians and Gynecologists. Obstet Gynecol. 2010;116:1241-4.
21. Screening and Diagnosis of Gestational Diabetes Mellitus. Committee Opinion No. 504. American College of Obstetricians and Gynecologists. Obstet Gynecol. 2011; 118:751-3.