The rising number of children and adults with obesity in the UK is a major public health concern. Without effective action there will be more than 1 million obese children in England (of a total of 8.5 million children aged 2–15 years) by 2010.¹ In December 2006 NICE published a guideline on the subject, covering both children and adults.² The National Collaborating Centre for Primary Care led on the clinical guidelines, and the Centre for Public Health Excellence at NICE led on the public health aspects (the first time NICE have produced separate public health guidance). The clinical guideline development group included Dr Penny Gibson, consultant community paediatrician and RCPCH advisor on childhood obesity, and a number of other paediatricians were co-opted as required.

The published scope of the guideline includes children down to the age of 2 years and referral criteria to specialised tertiary obesity services. It excludes population-based surveillance programmes and the management of comorbidities and conditions such as Prader-Willi syndrome that lead to obesity.

Detailed guidance is provided not only for the NHS but also for parents, nurseries and child care facilities, schools, local authorities, other public and private bodies and workplaces with the common aim of encouraging healthy eating and a physically active lifestyle. The guideline specifies the priorities for more research. The full guideline without references or evidence tables is 184 pages long, amounting in total to over 2500 pages including all the evidence tables. Two quick reference guides (15 and 27 pages long) summarise the public health³ and clinical⁴ recommendations for both adults and children. This review is focused on the clinical management of overweight and obesity in children.

Each study referred to was assigned a conventional level of evidence (1 for RCTs and systematic reviews and 2 for case …