Table 6

 Scottish Intercollegiate Guidelines Network11: management of obesity in children and young people

SIGN grade of recommendationRCPCH appraisal3
C, evidence from well conducted case control or cohort studies; D, evidence from non-analytic studies or expert opinion.
RCPCH, Royal College of Paediatrics and Child Health; SIGN, Scottish Intercollegiate Guidelines Network.
BMI centile should be used to identify childhood obesityCC
Obese children have a BMI >98th centileDNo comment
Treatment should only be considered whereD
‐ A child is defined as obese
‐ And the family are ready to make the necessary lifestyle changes
In most obese children weight maintenance is an acceptable goalD
Weight maintenance and/or weight loss can be achieved by sustained behavioural changes—for example, healthier eating, increased physical activity, reducing physical inactivityD
Prevention and treatment of obesity should be initiated in childhoodCC
Parental obesity should be recognised as a risk factor for childhood obesity to persist into adulthood
The following should be referred to a paediatric consultant before treatment is considered:D
‐ Children who may have a serious obesity related morbidity
‐ Children with a suspected underlying medical cause (including all <24 months of age)
‐ All children with BMI >99.6th centile
School family and societal interventions should be considered for the prevention of obesity in childrenNot in guidelineC