Ideas in this flowchart

• Childhood obesity prevention and management must support growth without excessive energy intake.
• Children need adequate calories for growth, and very restrictive diets should be avoided.
• Regularly exceeding caloric requirements can lead to childhood obesity.
• Childhood obesity is a major problem in North America; nearly one in three US children and adolescents is overweight or obese.
• Several environmental, behavioral, and social factors contribute to childhood obesity.
• Larger portions, limited access to nutrient-rich foods, and increased access to fast foods and vending machines contribute to the problem.
• Lack of breastfeeding support and declining physical education programs can contribute to childhood obesity.
• Insufficient physical activity, sedentary lifestyles, and media promoting unhealthy foods are contributing factors.
• Childhood obesity can produce long-term health and personal consequences.
• Children with obesity are more likely to become overweight or obese adults.
• Obesity can negatively affect self-esteem, energy, and activity level.
• Obesity increases the later risk of cardiovascular disease, Type 2 diabetes, stroke, hypertension, and certain cancers.
• A BMI percentile specific to age and sex is used to determine whether a child is overweight or obese.
• Age- and sex-specific percentiles are more appropriate than adult BMI categories because children's body composition changes with development and differs between boys and girls.
• Management focuses on nutrition, physical activity, behavior, and family support.
• Parents and caregivers should limit energy-dense, nutrient-poor snacks when weight gain is inappropriate for growth.
• Children should increase physical activity and limit sedentary activities such as television, video games, and Internet use.
• Programs may include behavior modification, exercise counseling, psychological support, family counseling, and family meal-planning advice.
• For most children, the goal is for height to catch up with weight rather than rapid weight loss.
• Rapid weight loss is not recommended for preteens or younger children because it can cause deficiencies and stunted growth.