• Mary R Nichols and Dora Livingston.
• Lee's Hill Medical Associate's, Fredericksburg, VA, USA. mrnichols@hsc.vcu.edu
• J Am Acad Nurse Prac. 2002 Feb 1;14(2):55-62; quiz 63-5.

PurposeTo review the literature on and discuss the role of the primary care provider in assessing and managing overweight children before they become obese.Data SourcesSelected research, national guidelines and recommendations, and the professional experience of the authors.ConclusionsThe focus of primary care involves early detection and family interventions that are designed for lifestyle modifications, specifically for improved nutrition and an increase in regular physical activity, to achieve optimal child health. Early identification and management of children who exceed a healthy weight for height, gender, and age will prevent the increasing incidence of pediatric obesity. Early prevention and management of pediatric overweight and obesity will also decrease the potential for associated medical and psychosocial problems.Implications For PracticePediatric obesity has risen dramatically in the United States during the last two decades; it is a significant child health problem that is preventable and largely under-diagnosed and under-treated. It is essential to discuss prevention of obesity with parents at every well-child visit; treatment should be initiated when patterns of weight gain exceed established percentiles for increasing height for age and gender.

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