Special considerations in childhood and adolescent obesity.

Child and adolescent obesity is increasingly prevalent in westernized countries. It is associated with significant medical and psychosocial co-morbidities that are both immediate and long-term. While genetic factors influence the susceptibility of a given child to an obesity-conducive environment, the current epidemic is due to massive environmental change over the past few decades leading to a rise in sedentary pursuits, a decrease in physical activity and increased energy intake. Effective management requires a family-focused, developmentally sensitive, behavioural management approach that addresses, for example, eating habits, incidental activity and television viewing. Prevention of childhood obesity will ultimately require multi-faceted, large-scale interventions.