Journal of Osteopathic Medicine, 2025/12, 125(12):A674–675. doi: 10.1515/jom-2025-2000, type of study: ,css,

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Keywords:

children [321]
cross sectional study [894]
family medicine [55]
obesity [26]
osteopaths [269]
pediatrics [573]
physicians [334]
USA [1751]

Abstract:

Objective: To evaluate physicians’ and resident physicians’ familiarity with and adherence to the American Academy of Pediatrics clinical practice guidelines for childhood obesity management. Context: Childhood obesity is a significant public health concern with long-term consequences for individual health and the healthcare system. The prevalence of childhood obesity has risen in recent decades, with approximately one in three children in the United States considered overweight and one in five classified as obese [1]. These rates have been further exacerbated by the COVID-19 pandemic and disproportionately affect rural and underserved populations [2]. Contributing factors include increased consumption of processed foods, reduced physical activity, and greater screen time—patterns consistent with the nutrition transition hypothesis, which describes global shifts in diet and activity linked to urbanization and economic change [3]. While healthcare providers play a pivotal role in early identification, prevention, and management of childhood obesity, existing evidence highlights gaps in provider training, knowledge, and adherence to clinical practice guidelines [4,5]. Methods: Physicians and resident physicians specializing in family medicine and pediatrics across Ohio were invited to complete a survey to assess their knowledge, confidence, and practices regarding the 2022 American Academy of Pediatrics clinical practice guidelines (CPGs) for childhood obesity management. Participants completed a modified version of the National Cancer Institute’s “Physician Survey of Practices on Diet, Physical Activity, and Weight Control: Questionnaire on Child/Adolescent Care” through an anonymous Qualtrics survey. The survey captured data on sociodemographic, practice patterns, and barriers to guideline adherence. Data were analyzed descriptively to identify trends and disparities in provider knowledge and practices. Results: A total of 145 providers completed the survey (40% residents or fellows; 68% women). Forty-two percent of the sample specialized in pediatrics or a pediatric specialty, while 44% practiced family medicine and 57% of respondents were osteopathic physicians. Most trainees practiced in a hospital setting (54%) while more attendings practiced in a group practice (46.6%). Participants generally indicated that they were somewhat familiar with the CPGs (46.9%), and 8.1% indicated being very familiar with the chronic care model as applied to pediatric obesity management. Pediatric providers indicated that they would begin random blood glucose testing (8.4 ± 2.1 y), fasting lipid screening (8.6 ± 2.2 y), and liver function testing (8.9 ± 2.4 y) for children with obesity earlier than is indicated by the CPGs (10 y), while family physicians would start later. (10.2 ± 3.6 y to 11.5 ± 11.5 y). None of the respondents correctly identified current physical activity recommendations for children, though 18.6% did correctly identify at least 60 minutes of moderate activity 7 days per week. Conclusions: These preliminary results suggest that family physicians and pediatric physicians in Ohio would benefit from continuing education regarding the current AAP CPGs for management of childhood obesity, including an overview of current lifestyle behavior recommendations and the role of the chronic care model in childhood obesity treatment.