title: Children's Hospital Association consensus statements for comorbidities of childhood obesity.
abstract: BACKGROUND
  Childhood obesity and overweight affect approximately 30% of US children. Many of these children have obesity-related comorbidities, such as hypertension, dyslipidemia, fatty liver disease, diabetes, polycystic ovary syndrome (PCOS), sleep apnea, psychosocial problems, and others. These children need routine screening and, in many cases, treatment for these conditions. However, because primary care pediatric providers (PCPs) often are underequipped to deal with these comorbidities, they frequently refer these patients to subspecialists. However, as a result of the US pediatric subspecialist shortage and considering that 12.5 million children are obese, access to care by subspecialists is limited. The aim of this article is to provide accessible, user-friendly clinical consensus statements to facilitate the screening, interpretation of results, and early treatment for some of the most common childhood obesity comorbidities.
  
  
  METHODS
  Members of the Children's Hospital Association (formerly NACHRI) FOCUS on a Fitter Future II (FFFII), a collaboration of 25 US pediatric obesity centers, used a combination of the best available evidence and collective clinical experience to develop consensus statements for pediatric obesity-related comorbidities. FFFII also surveyed the participating pediatric obesity centers regarding their current practices.
  
  
  RESULTS
  The work group developed consensus statements for use in the evaluation and treatment of lipids, liver enzymes, and blood pressure abnormalities and PCOS in the child with overweight and obesity. The results of the FFFII survey illustrated the variability in the approach for initial evaluation and treatment as well as pattern of referrals to subspecialists among programs.
  
  
  CONCLUSIONS
  The consensus statements presented in this article can be a useful tool for PCPs in the management and overall care of children with overweight and obesity.
authors.affiliation: 1 Division of Endocrinology, Connecticut Children's Medical Center, University of Connecticut , Hartford, CT.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Estrada
authors.forename: Ihuoma
authors.initials: I
authors.lastname: Eneli
authors.forename: Sarah
authors.initials: S
authors.lastname: Hampl
authors.forename: Michele
authors.initials: M
authors.lastname: Mietus-Snyder
authors.forename: Nazrat
authors.initials: N
authors.lastname: Mirza
authors.forename: Erinn
authors.initials: E
authors.lastname: Rhodes
authors.forename: Brooke
authors.initials: B
authors.lastname: Sweeney
authors.forename: Lydia
authors.initials: L
authors.lastname: Tinajero-Deck
authors.forename: Susan J
authors.initials: SJ
authors.lastname: Woolford
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Pont
mesh_terms: D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control; D050171:Dyslipidemias / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control; D007223:Infant; D008297:Male; D065626:Non-alcoholic Fatty Liver Disease / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control; D063766:Pediatric Obesity / Q000150:complications / Q000453:epidemiology* / Q000517:prevention & control; D011085:Polycystic Ovary Syndrome / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control; D012891:Sleep Apnea Syndromes / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control; D014481:United States / Q000453:epidemiology