In an effort to improve the care of children and adolescents with overweight or obesity, APA issued its Clinical Practice Guideline for Multicomponent Behavioral Treatment of Obesity and Overweight in Children and Adolescents in March 2018.
Nearly one in five children in the United States had obesity in 2015-16, according to the latest data from the National Health and Nutrition Examination Survey (NHANES). The rate of child obesity has more than tripled since the 1976-80 NHANES survey. Among teenagers, the rate quadrupled from 5 percent to more than 20 percent.
Children and teenagers with overweight are more likely to become adults with obesity, and are at greater risk of heart disease and many types of cancer. People with overweight and obesity also face stigma and bias throughout their lives. Children with obesity are more likely to suffer from depression, social isolation and low self-esteem, and are bullied more often than their peers.
Recommendations
The APA guideline is based on the best evidence to date. After reviewing the literature, APA strongly recommends family-based multicomponent behavioral interventions to treat overweight and obesity in children ages 2 to 18. These treatments encourage the entire family to engage in healthier behaviors—eat healthier foods, increase physical activity and reduce sedentary behavior. The interventions draw heavily from the science of behavior change and teach parents and older children and adolescents a variety of strategies, including goal setting, problem-solving, monitoring behavior and modeling positive behaviors.
The guideline also encourages psychologists and other providers to:
- Treat children and adolescents with overweight or obesity and their parents in a non-stigmatizing, nonjudgmental manner.
- Facilitate awareness of childhood obesity and overweight among parents.
- Address barriers to treatment with families.
- Advocate for financial coverage of treatment.
More research is needed
Most studies to date on family-based interventions have focused on school-age children—an age when parents can still significantly influence habits around diet and physical activity. Research has not yet identified how or whether intervention needs to be tailored to meet the needs of those children, particularly African-Americans and Latino/as, who are disproportionately affected by obesity. Additional evidence is also needed to determine whether specific intervention characteristics or strategies lead to greater adherence, engagement, or retention.
To read the full guideline, go to www.apa.org/obesity-guideline/clinical-practice-guideline.pdf (PDF, 892KB)opens in new window
APA has developed several sets of guidelines for psychological practice with particular populations. All APA practice guidelines are developed by task forces of experts, reviewed by APA boards and committees, and shared with the public for comment before they are adopted. This guideline is intended to be aspirational and is not intended to create a requirement for practice. APA guidelines do not take precedence over a psychologist’s informed professional judgment.