Sample Solution

2hours of screen time per day (no television viewing for children <2yr old)
• ≥ 1hour of physical activity daily
• Reinforce goals at each healthcare visit
• Allow child to self-regulate his/her meals and avoid overly strict eating regimens.
2. Structured weight management
• Structured daily meals and planned snacks with balanced macronutrients (breakfast, lunch, dinner, and 1 or 2 scheduled snacks, with no food or calorie containing beverages at other times)
• Emphasize food with low energy density (those with high fiber or water content)
• Reduce frequency and quantity of foods with high energy density (eg; fried foods, baked goods, fats)
• Limit portion size
• Set explicit behavior goals ≤ 1hour of screen time daily
• ≥1hour of physical daily, supervised
• Monthly patient-provider contact
• Monitor eating & physical activities through logs
• Use positive reinforcement techniques (reward system)
• Strong parental involvement for school aged children
3. Comprehensive multidisciplinary intervention
• Same as stage 2, along with structured diet & physical activity designed for negative energy balance behavioral interventions like development of short-term diet & physical activity goals.
• Weekly patient-provider contact (and/or phone) for a minimum of 8-12 weeks. Subsequently, monthly visits can help maintain new behaviors.