The epidemic of childhood obesity has led our society to critically evaluate our obesogenic culture and produced initiatives to prevent and treat obesity and its associated diseases. The Expert Committee Recommendations1 have helped provide an excellent guide to primary care doctors in the assessment and treatment of childhood obesity. The recommendations include staged treatment plans starting with prevention in the primary care office, advancing to structured weight management programs, and culminating in comprehensive, multidisciplinary intervention and tertiary care intervention. While the recommendations are useful for primary care physicians, they are less useful for physicians working with overweight children in the tertiary care facilities. This comment considers the aspects of the recommendations that our group (a tertiary care program providing multidisciplinary treatment and adolescent bariatric surgery at UCLA) views as most and least useful, as well as provides two suggestions for enhancing the effectiveness of the recommendations pertaining to tertiary care.
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