• Michigan Quality Improvement Consortium. Treatment of childhood overweight and obesity. Southfield (MI): Michigan Quality Improvement Consortium; 2008 Jun. 1 p.

This is the current release of the guideline.

This guideline updates a previous version: Michigan Quality Improvement Consortium. Treatment of childhood overweight. Southfield (MI): Michigan Quality Improvement Consortium; 2006 Nov. 1 p.

• Overweight
• Obesity

Evaluation
Management
Prevention
Risk Assessment

Family Practice
Internal Medicine
Nursing
Nutrition
Pediatrics

Advanced Practice Nurses
Dietitians
Health Plans
Physician Assistants
Physicians

• To achieve significant, measurable improvements in the specific treatment of childhood overweight and obesity through the development and implementation of common evidence-based clinical practice guidelines
• To design concise guidelines that are focused on key management components of childhood overweight to improve outcomes

Children 2 years of age or older with body mass index (BMI) in the following ranges:

• BMI ≥ 85^th percentile
• BMI ≥ 85^th to 94^th percentile (overweight) without risk factors or complications
• BMI ≥ 85^th to 94^th percentile with risk factors or complications
• BMI ≥ 95^th percentile (obese) with or without risk factors or complications

Evaluation

1. History and physical examination
   • Primary and secondary causes of obesity
   • General and weight-related comorbidities
   • Signs and symptoms
   • Pulse and blood pressure
   • Laboratory tests
   • Monitor body mass index (BMI)

2. Risk assessment

Prevention/Management/Treatment

1. Reinforcement of prevention recommendations
2. Lifestyle interventions and behavior modification to reach weight maintenance
3. Dietary regulation of body weight and fat based on BMI percentile
4. Treatment of risk factors and complications
5. Specialist referrals

Not stated

Searches of Electronic Databases

The Michigan Quality Improvement Consortium (MQIC) project leader conducts a search of current literature in support of the guideline topic. Computer database searches are used to identify published studies, existing protocols and/or national guidelines on the selected topic developed by organizations such as the American Diabetes Association, American Heart Association, American Academy of Pediatrics, etc. If available, clinical practice guidelines from participating MQIC health plans and Michigan health systems are also used to develop a framework for the new guideline.

Not stated

Weighting According to a Rating Scheme (Scheme Given)

Levels of Evidence for the Most Significant Recommendations

1. Randomized controlled trials
2. Controlled trials, no randomization
3. Observational studies
4. Opinion of expert panel

Review

Not stated

Expert Consensus

Using information obtained from literature searches and available health plan guidelines on the designated topic, the Michigan Quality Improvement Consortium (MQIC) project leader prepares a draft guideline to be reviewed by the medical directors' committee at one of their scheduled meetings. Priority is given to recommendations with [A] and [B] levels of evidence (see "Rating Scheme for the Strength of the Evidence" field).

The initial draft guideline is reviewed, evaluated, and revised by the committee resulting in draft two of the guideline. Additionally, the Michigan Academy of Family Physicians participates in guideline development at the onset of the process and throughout the guideline development procedure. The MQIC guideline feedback form and draft two of the guideline are distributed to the medical directors, as well as the MQIC measurement and implementation group members, for review and comments. Feedback from members is collected by the MQIC project leader and prepared for review by the medical directors' committee at their next scheduled meeting. The review, evaluation, and revision process with several iterations of the guideline may be repeated over several meetings before consensus is reached on a final draft guideline.

Not applicable

A formal cost analysis was not performed and published cost analyses were not reviewed.

External Peer Review
Internal Peer Review

When consensus is reached on the final draft guideline, the medical directors approve the guideline for external distribution to practitioners with review and comments requested via the Michigan Quality Improvement Consortium (MQIC) health plans (project leader distributes final draft to medical directors' committee, measurement and implementation groups to solicit feedback).

The MQIC project leader also forwards the approved guideline draft to appropriate state medical specialty societies for their input. After all feedback is received from external reviews, it is presented for discussion at the next scheduled committee meeting. Based on feedback, subsequent guideline review, evaluation, and revision may be required prior to final guideline approval.

The MQIC Medical Directors approved this guideline in June 2008.

None provided

Through a collaborative approach to developing and implementing common clinical practice guidelines and performance measures for specific treatment interventions for childhood overweight and obesity, Michigan health plans will achieve consistent delivery of evidence-based services and better health outcomes. This approach also will augment the practice environment for physicians by reducing the administrative burdens imposed by compliance with diverse health plan guidelines and associated requirements.

Not stated

This guideline lists core management steps. Individual patient considerations and advances in medical science may supersede or modify these recommendations.

Getting Better
Living with Illness
Staying Healthy

Effectiveness

• Michigan Quality Improvement Consortium. Treatment of childhood overweight and obesity. Southfield (MI): Michigan Quality Improvement Consortium; 2008 Jun. 1 p.

2006 Nov (revised 2008 Jun)

Michigan Quality Improvement Consortium - Professional Association

Michigan Quality Improvement Consortium

Michigan Quality Improvement Consortium Medical Director's Committee

Physician representatives from participating Michigan Quality Improvement Consortium health plans, Michigan State Medical Society, Michigan Osteopathic Association, Michigan Association of Health Plans, Michigan Department of Community Health and Michigan Peer Review Organization

Standard disclosure is requested from all individuals participating in the Michigan Quality Improvement Consortium (MQIC) guideline development process, including those parties who are solicited for guideline feedback (e.g., health plans, medical specialty societies). Additionally, members of the MQIC Medical Directors' Committee are asked to disclose all commercial relationships.

This is the current release of the guideline.

This guideline updates a previous version: Michigan Quality Improvement Consortium. Treatment of childhood overweight. Southfield (MI): Michigan Quality Improvement Consortium; 2006 Nov. 1 p.

None available

This NGC summary was completed by ECRI Institute on July 13, 2007. The information was verified by the guideline developer on July 16, 2007. This NGC summary was updated by ECRI Institute on December 15, 2008. The updated information was verified by the guideline developer on December 17, 2008.

This NGC summary is based on the original guideline, which may be reproduced with the citation developed by the Michigan Quality Improvement Consortium.