Version June 2024
| A multicomponent intervention is recommended, focusing on modifying diet and physical activity. This is implemented through nutrition counseling, with family participation. |
| Assessment and intervention should focus on the following: |
| Eating habits: |
| Reduce total dietary fat and calorically sweetened beverages |
| Promote intake of vegetables and fruits |
| Reduce consumption of food away from home |
| Reduce portion sizes |
| Do not skip breakfast |
| Parental guidance: |
| Do not strictly restrict highly palatable foods, because this is predicted to lead to covert consumption |
| Do not pressure the child to eat or use food as a reward |
| Energy intake goals: |
| Children 6 to 12 years – Balanced macronutrient diet, no fewer than 900 kcal per day |
| Adolescents 13 years and older – Balanced macronutrient diet, no fewer than 1200 kcal per day |
| For children and adolescents who are >120% of ideal body weight with serious medical complications that require rapid weight loss, a medically supervised Protein-Sparing Modified Fast Diet (PSMF) may be utilized in a short-term intervention (typically 10 weeks) |
| Physical activity goals: |
| Moderate to vigorous physical activity for at least 1 hour daily |
| Restrict nonacademic screen time (eg, television use) to less than 2 hours daily |
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