Pediatric Weight Management

Pediatric Weight Management

Welcome to the Pediatric Weight Management (PWM) Guideline and supporting Systematic Review  

A review of the available science on treatment of childhood obesity in a multicomponent, multidisciplinary context resulted in the release of the 2007 PWM evidence-based guides for practice.  A second systematic review, targeting aspects of the built environment, food access, and school-based interventions was published on the EAL in 2011 and 2012.

More recently (2012-2015), a panel of experts appointed by the Academy, reviewed the EAL pediatric weight management content and developed guidelines based on new science. A highly structured data extraction tool, developed by the Academy, was used in the systematic review process  to conduct a more rigorous analysis and in-depth syntheses of the evidence.  

The workgroup focused on two topic areas:
  • Multicomponent PWM Interventions and Weight Status Outcomes (BMI, Waist Circumference, BMI Z-score, BMI Percentile)
  • Treatment Context in Multicomponent PWM Interventions [Family participation, length of treatment, treatment setting (clinic vs. outside the clinic), group sessions (vs. individual sessions only] and Weight Status Outcomes
The 2015 PWM guideline complements and supports the 2007 guideline. Download the PWM Guideline Comparison Table to see changes between the newly published and previous guideline. Since not all of the 2007 recommendations were updated/reviewed, the results of the previous systematic reviews remain an accessible resource.  

Use the left navigation bar to view the 2015 guidelines and supporting evidence.  Expand the sections below for a listing of individuals who contributed to the development of these projects.
 
  • Project Team (2012-2015)
    The following individuals contributed their valuable time and expertise to this project:

    Workgroup Members
    • Nancy Copperman, MS, RDN, CND, Chair 
    • Beverly Henry, PhD, RDN, LDN
    • Melanie Hingle, PhD, MPH, RDN (through 12/2014)
    • Dana E. Gerstein, MPH, RDN
    • Linda Arpino, MA, RDN, CDN
    • Jodie Shield, MEd, RDN
    • Jane Ziegler, DCN, RDN, LDN, CNSD 
    Project Manager
    • Mujahed Khan, MBA, RDN* (through 11/2014)
    • Tami Piemonte, MS, RDN, LDN  (beginning 12/2014)
    Lead Analysts
    • Sue Benson-Davies, PhD, DCN, MPH, RDN (through 11/2014)
    • Deepa Handu, PhD, RD, LDN* 
    • J. Scott Parrott, PhD
     Evidence Analysts
    • Ellen Bowser, MS, RD, LD/N
    • Christina Campbell, PhD, RD, LN
    • Micah Lancman, MS, RD
    • Megan Majernik, RD, LDN, MS
    * Indicates Academy Staff Member
    Guideline Reviewers
    • Christina K. Biesemeier, MS, RDN, FADA, FAND
    • Heather Burns, MEd, RDN, LD, CDE
    • Marion J. Franz, MS, RDN, CDE
    • Marc Jacobson, MD
    • Mary Mullen, MS, RDN, LDN
    • Theresa Loomis, DCN, RD
    • Pamela Reichert-Anderson, MA, RD, CDN
    • Denise Sofka, MPH, RD
    • Josefine Wendel, MS, RDN, CDN
    Academy Staff
    • Paula J. Ziegler, PhD, RD, CFS (through June 2015)

    Financial Contributor
    • Academy of Nutrition and Dietetics


    Disclosures of Potential Conflicts of Interest: In the interest of full disclosure, the Academy has adopted the policy of revealing relationships workgroup members have with companies that sell products or services that are relevant to this topic. Workgroup members are required to disclose potential conflicts of interest by completing the Academy Conflict of Interest Form. It should not be assumed that these financial interests will have an adverse impact on the content, but they are noted here to fully inform readers.
    • Nancy Copperman:  received honorarium by Commission on Dietetic Registration for work at CDR Certificate of Training in Pediatric Weight Management program.
    • Dana Gerstein: received honorarium by Commission on Dietetic Registration for work at CDR Certificate of Training in Pediatric Weight Management program.
    • Jane Ziegler: awarded Academy of Nutrition and Dietetics Foundation Colgate Award
  • Project Team (2003-2009)
    The following individuals contributed their valuable time and expertise to the Childhood Overweight projects:

    Workgroup Members (Treatment)
    • Christina W. Biesemeier, MS, RD, LD, FADA, Chair
    • Joyce B. Bittle, PhD, RD, LDN
    • Nancy Copperman, MS, RD, CND
    • Heather S. Holden, Med RD, LD, CDE
    • Shelley Kirk, PhD, RD, LD
    • Aida C. G. Miles, MMSc, RD, LD
    • Lorrene D. Ritchie, PhD, RD
    • Denise Sofka, MPH, RD
    Workgroup Members (Prevention)
    • Patricia B. Crawford, DrPH, RD
    • Dana E. Gerstein, MPH, RD
    • Karen E. Peterson, PhD, RD
    • Lorrene D. Ritchie, PhD, RD
    • Greg Welk, PhD
    Project Manager/Lead Analst
    • J. Scott Parrott, PhD 
    Project Director
    • Esther F. Myers, PhD, RD, FADA
    Evidence Analysts
    • Lisa A. Davis, MS, RD
    • Debby K. Demory-Luce, PhD, RD, LD
    • Michelle Ihmels, MS
    • Sarah Kim , MPH
    • Sarah Krathwohl, MPH
    • Jodee Schaben, PhD
    Association Positions Committee Workgroup
    • Lorrene D. Ritchie, PhD, RD
    • Denise Sofka, MPH
    Position Paper Authors
    • Lorrene D. Ritchie, PhD, RD
    • Patricia B. Crawford, DrPH, RD
    • Deanna M. Hoelscher, PhD, RD
    • Melinda S. Sothern, PhD
    Guideline Reviewers
    • William H. Dietz, MD, PhD
    • David Frankenfield, MS, RD
    • Marion J. Franz, MS, RD, CDE
    • M. Patricia Fuhrman, MS, RD, LD, FADA
    • Van S. Hubbard, MD, PhD
    • Marc S. Jacobson, MD
    • Donna B. Johnson, PhD, RD
    • Elvira Q. Johnson, MS, RD, CDE, LDN
    • Rita M. Johnson, PhD, RD, LDN, FADA
    • Capt. Audrey M. Koertvelsyessy, MSN, MA, FNP
    • Nancy M. Lewis, PhD, RD, FADA
    • Kathleen C. Niedert, MBA, RD, LD, FADA
    • Kimberly Robien, PhD, RD, FADA, CNSD
    • Dennis Styne, MD
    • Margaret J. Tate, MS, RD
    Academy Staff
    • Deborah Cummins, PhD
    • Cathy Devlin, RD
    • Kari Kren, MPH, RD
    • Esther F. Myers, PhD, RD
    Financial Contributors
    • Academy of Nutrition and Dietetics
    • Academy of Nutrition and Dietetics Foundation
    • Centers for Disease Control and Prevention
    • Dairy Management, Inc.
    • National Dairy Council
    Disclosures of Potential Conflicts of Interest: In the interest of full disclosure, the Academy has adopted the policy of revealing relationships workgroup members have with companies that sell products or services that are relevant to this topic. Workgroup members are required to disclose potential conflicts of interest by completing the Academy Conflict of Interest Form. It should not be assumed that these financial interests will have an adverse impact on the content, but they are noted here to fully inform readers.
    • Nancy M. Copperman - recieved and honorarium for the Certificate of Training in Child and Adolescent Weight Managaement Course
    • Lorrene Ritchie - received grants/resarch support from Iacocca Foundation, Atkins Foundation, Gilbert
  • Project Team (2009-2012)
    The following individuals contributed their valuable time and expertise to this project:

    Workgroup Members
    • Heather Holden, MEd, RD, LDN, Chair
    • Linda Arpino, MA, RD, CDN
    • Nancy Copperman, MS, RD, CDN
    • Dana Gerstein, MPH, RD
    • Beverly Henry, PhD, RD, LDN
    • Jodie Shield, MEd, RD
    Project Manager
    • J. Scott Parrott, PhD
    • Chung, PhD, MPH
    Evidence Analysts
    • Carol Klitzke, MS, RD
    • Ellen K. Bowser, MS, LDN, CSP
    • Elizabeth Droke, PhD, RD
    Association Positions Committee Workgroup
    • Carol Berg Sloan, RD
    • Diane Sowa, MBA, RD
    • Karen P. Lacey, MS, RD, CD
    Academy Staff
    • Deborah Cummins, PhD
    • Kari Kren, MPH, RD
    • Marla Richards, MS, RD, LD
    • Joan Schwaba, MS, RD, LDN
    • Esther Myers, PhD, RD, FADA 
    Financial Contributor
    • Academy of Nutrition and Dietetics

    Disclosures of Potential Conflicts of Interest: In the interest of full disclosure, the Academy has adopted the policy of revealing relationships workgroup members have with companies that sell products or services that are relevant to this topic. Workgroup members are required to disclose potential conflicts of interest by completing the Academy Conflict of Interest Form. It should not be assumed that these financial interests will have an adverse impact on the content, but they are noted here to fully inform readers.
    • None of the workgroup members listed above disclosed potential conflicts
  • Project Resources
    The following resources were developed from these projects:
    • Postion Paper: Interventions for the Prevention and Treatment of Pediatric Overweight and Obesity - Abstract: It is the position of the Academy of Nutrition and Dietetics that prevention and treatment of pediatric overweight and obesity require systems-level approaches that include the skills of registered dietitians, as well as consistent and integrated messages and environmental support across all sectors of society to achieve sustained dietary and physicalactivity behavior change. This position paper provides guidance and recommendations for levels of intervention targeting overweight and obesity prevention and treatment from preschool age through adolescence. Methods included a review of the literature from 2009 to April 2012, including the Academy’s 2009 evidence analysis school-based reviews. Multicomponent interventions show the greatest impact for primary prevention; thus, early childhood and school-based interventions should integrate behavioral and environmental approaches that focus on dietary intake and physical activity using a systems-level approach targeting the multilevel structure of the socioecological model as well as interactions and relationships between levels. Secondary prevention and tertiary prevention/treatment should emphasize sustained family-based, developmentally appropriate approaches that include nutrition education, dietary counseling, parenting skills, behavioral strategies, and physical-activity promotion. For obese youth with concomitant serious comorbidities, structured dietary approaches and pharmacologic agents should be considered, and weight-loss surgery can be considered for severely obese adolescents. Policy and environmental interventions are recommended as feasible and sustainable ways to support healthful lifestyles for children and families. The Academy supports commitment of resources for interventions, policies, and research that promote healthful eating and physical-activity behaviors to ensure that all youth have the opportunity to achieve and maintain a weight that is optimal for health. J Acade Nutr Diet 2013;113:1375-1394 (PDF)
       
    • Position of the American Dietetic Association: Individual, Family, School and Community-based Intervention Programs for Pediatric Overweight - Abstract: The American Dietetic Association (ADA), recognizing that overweight is a significant problem for children and adolescents in the United States, takes the position that pediatric overweight intervention requires a combination of family-based and school-based multicomponent programs that include the promotion of physical activity, parent training/modeling, behavioral counseling, and nutrition education. Furthermore, although not yet evidence-based, community-based and environmental interventions are recommended as among the most feasible ways to support healthful lifestyles for the greatest numbers of children and their families. ADA supports the commitment of resources for programs, policy development, and research for the efficacious promotion of healthful eating habits and increased physical activity in all children and adolescents, regardless of weight status. This is the first position paper of ADA to be based on a rigorous systematic evidence-based analysis of the pediatric overweight literature on intervention programs. The research showed positive effects of two specific kinds of overweight interventions: a) multicomponent, family-based programs for children between the ages of 5 and 12 years, and b) multicomponent, school-based programs for adolescents. Multicomponent programs include behavioral counseling, promotion of physical activity, parent training/modeling, dietary counseling, and nutrition education. Analysis of the literature to date points to the need for further investigation of promising strategies not yet adequately evaluated. Furthermore, this review highlights the need for research to develop effective and innovative overweight prevention programs for various sectors of the population, including those of varying ethnicities, young children, and adolescents. To support and enhance the efficacy of family- and school-based weight interventions, community-wide interventions should be undertaken; few such interventions have been conducted and even fewer evaluated. J Am Diet Assoc. 2006;106:925-945. (PDF)
       
    • Fighting Childhood Obesity - How to Achieve and Maintain a Healthy Weight in Children and Teens - This brochure, designed for the general public, provides practical tips to encurage healthy eating habits in children. It includes a comprehensive list of resources. Click to order.
       
    • Pediatric Weight Management 2007 GuideiineToolkit - this toolkit is designed to assist the registered dietitian in applying the Academy's Pediatric Weight Management 2007 Evidence-Based Nutrition Practice Guideline. The toolkit includes resources such as the MNT summary of recommendations for critical illness, MNT encounter process, MNT protocol, sample documentation forms, client education resources an doutcomes monitoring forms. It also incorporates the Academy Nutrition Care Process and Standardized Language for patient/client care. Click to order.  
       
    • PWM 2015 Guideline Presentation - this 32-slide MS PowerPoint presentation includes all the recommendations and ratings of the PWM 2015 Evidence-based Nutrition Practice Guideline. Ideal for you to use for meetings, in-service presentations and classes (This product is not designed for the consumer). Click to order.