1. Caloric Needs
1.1. equations are used for plotting at >85th for age
1.2. equation for maintenance of weight
1.3. loss of 1/2 to 1 pound decrease caloric needs by 250 -500kcal/day
2. stages of treatment
2.1. stage 1
2.1.1. parameters set
2.1.1.1. more than 5 fruits
2.1.1.2. less than 2 hours of screen time a day
2.1.1.3. 1 hour of physical activity daily
2.1.1.4. no sugar sweetened beverages
2.1.1.5. limiting eating out
2.1.1.6. whole family change
2.1.1.7. reassess in 4-6 weeks
2.2. stage 2
2.2.1. referral to dietitian for more structured meal pla
2.2.2. increase time spent in physical activity
2.2.3. further limit screen time to less than one hour a day
2.2.4. investigate barriers to compliance
2.2.5. reassess in 4-6 weeks
2.3. Stage 3
2.3.1. comprehensive multi disciplinary treatment
2.3.2. assess in 4-6 weeks
2.4. stage 4
2.4.1. continue with diet and activity counseling plus consider
2.4.1.1. meal replacement
2.4.1.2. very low calorie diet
2.4.1.3. medication
2.4.1.4. surgery
3. 2-19 years old
3.1. overweight
3.1.1. BMI for age 85th to 94th precentile
3.2. Obese
3.2.1. BMI for age>/= 95th precentile