Navigating Pediatric Obesity: Tools and Strategies for Success in Primary Care

Announcer:
You’re listening to Clinician’s Roundtable on ReachMD. On this episode, Dr. Jaime Moore will discuss the management of pediatric obesity, which she spoke on at the 2025 American Academy of Pediatrics National Conference and Exhibition. Dr. Moore is an Assistant Professor of Pediatric Nutrition at the University of Colorado Anschutz School of Medicine and part of the Children’s Hospital Colorado Lifestyle Medicine Program. Let’s hear from her now.

Dr. Moore:
I think one of the biggest challenges pediatricians can face is how to discuss obesity as a potential health concern to then be able to open the door to a treatment conversation. We know that weight is a topic that can be very sensitive. It’s the subject to lots of societal expectations and is shaped by unique cultural beliefs and norms. And when we think about trying to balance the desire to clearly communicate possible health risks of extra weight on the body while also empowering a child and family to embrace healthy behaviors in a way that matches that specific family’s level of readiness and access, it can be really tricky.

But we do have many tools. One of the ones that I’ll highlight is brief motivational interviewing. And this remains a really powerful tool for not only pediatric obesity, but many other chronic illnesses, and it can be a practical strategy to incorporate into what we know are just jam-packed primary care visits. Motivational interviewing often begins with asking permission to discuss how the child has been growing or asking permission to share your concerns, and respecting the family’s answer when you are asking permission is key. That ask really does go a long way.

Another challenge is that the first ever AAP clinical practice guideline for pediatric obesity in 2023 recommends increased ownership of pediatric obesity treatment in primary care, and what many primary care providers have reflected over the last couple of years is that there is a need and an opportunity for additional education, skill-building, and support so that they are able to best deliver pediatric obesity treatment. And we know that most medical school, residency, and advanced practice provider programs unfortunately still don’t provide comprehensive training in nutrition or obesity management. Several of my primary care colleagues have noted that their increased management of conditions like anxiety and depression over the last several years could be a really helpful model or parallel to thinking about how we increase adoption of pediatric obesity treatment.

One great resource that I want to mention is the AAP’s Institute for Healthy Childhood Weight website. This has been iteratively updated since 2023 and is really a central hub for education, including some self-paced modules for continuing medical education credit. There are patient and family-facing materials in English and Spanish.

Additionally, many states have dedicated pediatric obesity management programs. These remain great resources, not only for expertise to help manage cases with the highest complexity, but they can also be really helpful partnerships to develop so a provider can reach out via e-mail or call or e-consult when a question comes up about the evaluation or treatment that you need an assist with. I think that near real-time help plays a really big role in developing self-efficacy in this space.

Next, access to pediatric obesity treatment and its various components does differ based on geographic location, insurance coverage, and social determinants of health. Some of the strategies that can be leveraged include ongoing utilization of telehealth and working with your practice group on resource mapping in your community related to nutrition, physical activity, sleep, and mental health, and some practices have found it really helpful to identify an internal obesity medicine champion.

And finally, I think a potential universal barrier can be implicit bias about obesity. All humans have implicit biases. We use them to help navigate the world around us. And these can include internalized beliefs about people in larger bodies, including children in larger bodies. I think the key is to bring those implicit biases to our consciousness to be able to effectively challenge and minimize them. And there isn’t one right way to check our biases.

Personally, I use a mantra that one of my amazing patients shared. She said, “Don’t let my weight be the first thing you see when you walk into the room.” So I say that to myself before knocking on the door to enter the patient’s room in our lifestyle medicine clinic, just as an example.

Announcer:
That was Dr. Jaime Moore discussing pediatric obesity management, which she spoke on at the 2025 American Academy of Pediatrics National Conference and Exhibition. To access this and other episodes in our series, visit Clinician’s Roundtable on ReachMD.com, where you can Be Part of the Knowledge. Thanks for listening!