Pediatric Weight Management (PWM) Nutrition Education in the Treatment of Pediatric Obesity
Click here to see the explanation of recommendation ratings (Strong, Fair, Weak, Consensus, Insufficient Evidence) and labels (Imperative or Conditional). To see more detail on the evidence from which the following recommendations were drawn, use the hyperlinks in the Supporting Evidence Section below.
PWM: Tailor Nutrition Education to Nutrition Prescription
In a multi-component program, if there is a Nutrition Diagnosis for food and nutrition-related knowledge deficit, then Nutrition Education should be tailored to the Nutrition Prescription. Research shows that if nutrition education is not tailored to nutrition prescription, improvement in weight status is not consistent.
Risks/Harms of Implementing This Recommendation
Conditions of Application
The patient or the patient's family will almost always need some form of Nutrition Education. It is imperative that patient education be tailored to the specific knowledge deficits identified in the Nutrition Assessment.
According to the Nutrition Diagnosis and Intervention: Standardized Language of the Nutrition Care Process:
Nutrition Education is a formal process to instruct or train a patient/client in a skill or to impart knowledge to help the patients/clients voluntarily manage or modify food choices and eating behavior to maintain or improve health...In [some] cases the patient/client knows what to do but has been unable to make or sustain a behavioral change. (p.191).
Thus, the dietitian must distinguish between the etiology or cause of the problem. If the patient or client or their family demonstrates adequate knowledge, but are still unable to make the behavioral changes, then nutrition education should be tailored to take advantage of existing knowledge to support the desired behavior change.
Thus, it is critical for the nutrition education intervention be closely coordinated with the Nutrition Prescription.
Potential Costs Associated with Application
Absence of health insurance coverage for weight management could limit program access.
Results from studies that include Nutrition Education without a prescribed diet plan are less consistent than results where nutrition education interventions were integrated with the Nutrition Prescription:
- See the evidence questions in the Supporting Evidence section below
- These findings are in contrast to the outcomes reported from studies that integrated nutrition education with an individualized nutrition prescription. See Pediatric Weight Management (PWM) Nutrition Prescription in the Treatment of Pediatric Obesity.
Recommendation Strength Rationale
A strong body of research indicates much more consistent results when Nutrition Education is tailored to an individualized Nutrition Prescription [Grade I for combined nutrition prescription and nutrition education, Grade III (children) and Grade II (adolescents) for nutrition education alone.]
- Risks/Harms of Implementing This Recommendation
The recommendations were created from the evidence analysis on the following questions. To see detail of the evidence analysis, click the blue hyperlinks below (recommendations rated consensus will not have supporting evidence linked).
What is the effectiveness of using nutrition education without a prescribed diet plan as the dietary component of a multicomponent pediatric weight management program in children (ages 6-12)?
What is the effectiveness of using nutrition education without a prescribed diet plan as the dietary component of a multicomponent pediatric weight management program in adolescents (ages 13-18)?
Brownell KD, Kelman JH, Stunkard AJ. Treatment of obese children with and without their mothers: changes in weight and blood pressure. Pediatrics 1983; 71: 515-23.
Coates TJ, Killen JD, Slinkard LA. Parent participation in a treatment program for overweight adolescents. Int J Eat Disord 1982; 1: 37-48.
de Mello ED, Luft VC, Meyer F. Individual outpatient care versus group education programs. Which leads to greater change in dietary and physical activity habits for obese children? J Pediatr (Rio J). 2004 Nov-Dec;80(6):468-74.
Golan M, Weizman A, Apter A, Fainaru M. Parents as the exclusive agents of change in the treatment of childhood obesity. Am J Clin Nutr 1998;67:1130-1135.
Gutin B, Barbeau P, Owens S, Lemmon C, Bauman M, Allison J, Kang H, Litaker M. Effects of exercise intensity on cardiovascular fitness, total body composition, and visceral adiposity of obese adolescents Am J Clin Nutr 2002;75:818-26.
Israel AC, Guile CA, Baker JE. An evaluation of enhanced self-regulation training in the treatment of childhood obesity. J Pediatr Psychol 1994; 19:737-49.
Kirschenbaum DS, Harris ES, Tomarken AJ. Effects of parental involvement in behavioral weight loss therapy for preadolescents. Behavior Therapy 1984;15:485-500.
Mellin LM, Slinkard LA, Irwin CE. Adolescent obesity intervention: validation of the SHAPEDOWN program. J Am Diet Assoc 1987; 87:333-8.
Resnicow K, Yaroch AL, Davis A, Wang DT, Carter S, Slaughter L, Coleman D, Baranowski T. GO GIRLS!: results from a nutrition and physical activity program for low-income, overweight African American adolescent females. Health Education & Behavior 2000;27:616-31.
References not graded in Academy of Nutrition and Dietetics Evidence Analysis Process
International Dietetics & Nutrition Terminology (IDNT) Reference Manual: Standardized Language for the Nutrition Care Process. 2007. American Dietetic Association.