Statistics from Altmetric.com
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 …
↵i such as hypertension, hyperinsulinaemia, dyslipidaemia, type 2 diabetes, psychosocial dysfunction and exacerbation of conditions such as asthma
↵ii Endocrine tests are not routinely recommended unless there is other evidence of endocrine disease or short stature. Many overweight children and adolescents have cutaneous striae; investigation for Cushing’s disease is not recommended unless the patient is hypertensive with growth delay, and obesity is of recent onset.
↵iii At the time of publication (December 2006), orlistat and sibutramine do not have UK marketing authorisation for use in children. Prescribers should be aware of the special considerations and issues when prescribing for children.
Competing interests: None.
If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.