Outpatient Specialty Care and Primary Care Clinical Pathway
for Obesity Prevention and Management in Children

Well Child Visit with Provider
for Child ≥ 2 years
Severe Obesity
Initial Primary Care
Overweight/Obesity Management
  1. Add appropriate BMI diagnosis to
    problem list
  2. Assess and Evaluate Comorbidities
  3. BMI-based screening labs
  4. Engage family in one behavioral goal related to 5210 messaging
  5. Evaluate family’s access to healthy foods & exercise
  6. Tips for discussing weight with families
If interested in making a change
Targeted
Primary Care

Every 1-2 Months
Continue for 6 months
Nurse Educator, if available, and/or referral to Registered Dietician for additional nutrition counseling
Patient/Family
Interested in
More Frequent Visits
Healthy Weight
5th to < 85th percentile
Overweight
85th to < 95th percentile
Overweight/Obesity
Prevention
  1. Continue 5210 Messaging
  2. Check trend of BMI
  3. Assess for risk factors
  4. Evaluate family’s access to healthy foods & exercise
  5. Reassess at each visit
Patient/Family
Not Interested in
More Frequent Visits
  1. Weight check every 3-6 months
  2. Reassess interest in more frequent visits
Class I Obesity
95th percentile to
< 120% of the 95th
percentile
Class II Obesity
≥ 120% of the 95th percentile
Class III Obesity
≥ 140% of the 95th percentile
Consider Initial Primary Care
Management or Referral to
Healthy Weight Program
Consider Initial Primary Care
Management or Referral to
Healthy Weight Program or Adolescent Bariatric Referral
Maintaining or trending down
Reassess weight and BMI percentile at 6 months
Continue current plan with available office resources
Gaining or trending up
Posted: July 2014
Updated: June 2017, September 2019, April 2021, July 2021
Authors: E. Parks Prout, MD, MSCE; J. Michel, MD, MHS; M. O’Bryne, MD; B. Van Remortel, MD, MPH, E. Coover, RD