At a recent conference in the US, experts gathered to discuss the implementation of and access to health services for managing pediatric obesity.
Given the differences in how health care is delivered and paid for in Canada and the US, issues related to reimbursement for weight management vary between our countries. However, principles and practices regarding obesity management are more universal; there is a lot of available evidence to guide care, including family-based treatment, intervention dose/intensity, parental involvement, treatment modality, as well as clinical team composition and training (see pdf here: wilfley-et-al-2016).
For instance, interventions that (1) include an individualized approach to care via 1-on-1 and/or group-based programming, (2) include >25 hours of contact hours over 6 to 12 months, (3) integrate a chronic care model of monitoring and support over time, and (4) optimize clinicians’ competence and clinical skill all lead to better treatment outcomes for children and families.
While these directives may be evidence-based and represent the ideal, we know that a number of barriers influence the health services that clinicians offer (e.g., availability, training) and the care that families receive (e.g., treatment engagement, attrition, motivation). In many respects, we have very good evidence to guide WHAT treatment should include; however, many questions still remain regarding HOW treatment is offered to maximize uptake and participation among families.