Best Practice the Obese Child

Correspondence to: Professor Mary C J Rudolf, Department of Community Paediatrics, Belmont House, 3–5 Belmont Grove, Leeds LS17 8DR, UK; mary.rudolf@ leedsth.nhs.uk _________________________ C hildhood obesity has now reached epidemic proportions, and large numbers of children are presenting for medical care. The Royal College of Paediatrics and Child Health (RCPCH) has produced a document contending that most of these children should be seen in primary care. However the House of Commons Health Select Committee sees otherwise and has called upon the National Health Service to ensure obese children have access to specialist care. The paediatrician’s role in managing obesity therefore needs clarifying, particularly in the context that any recommendations for identification, investigation, and treatment have enormous financial and service implications. In this article I map out what is known about the diagnosis, epidemiology, complications, and treatment of the condition, and conclude by examining published guidelines with some thoughts about the shape that services might take.