Paeds Cases · endocrinology-diabetes-and-growth
Childhood obesity assessment and staged management OSCE — classification, comorbidity screening and weight-neutral planning
Observed structured encounter testing childhood obesity classification using BMI-for-age, systematic comorbidity screening, selective secondary-cause exclusion, weight-neutral family counselling with motivational interviewing, and staged management planning with parallel comorbidity-directed care.
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Target exams
RACP General PaediatricsRACP DCEMRCPCH ClinicalRCPSC Pediatrics
Prompt
Station A is a 10-year-old boy with his father, where a BMI above the 97th percentile has been noted and the father asks whether his son is sick and what to do. Station B is assessment and planning of a 15-year-old girl with severe obesity, impaired glucose tolerance and an elevated ALT, requiring staged management and comorbidity-directed care.
Station objectives
- Classify childhood obesity using BMI-for-age and identify severe-obesity thresholds and the adult crossover. [1]
- Screen systematically for comorbidity across six systems and order the baseline panel. [1] [2]
- Exclude secondary and syndromic causes selectively, guided by red-flag features. [2]
- Deliver weight-neutral lifestyle counselling using motivational interviewing and build a staged management plan with parallel comorbidity-directed care. [1] [5]
References6ShowHide
- [1]Hampl SE, Hassink SG, Skinner AC Clinical Practice Guideline for the Evaluation and Treatment of Children and Adolescents With Obesity. Pediatrics, 2023.PMID 36622115
- [2]Styne DM, Arslanian SA, Connor EL Pediatric Obesity-Assessment, Treatment, and Prevention: An Endocrine Society Clinical Practice Guideline. Journal of clinical endocrinology and metabolism, 2017.PMID 28359099
- [5]Kelly AS, Barlow SE, Rao G Severe obesity in children and adolescents: identification, associated health risks, and treatment approaches: a scientific statement from the American Heart Association. Circulation, 2013.PMID 24016455
- [6]Inge TH, Laffel LM, Jenkins TM Comparison of Surgical and Medical Therapy for Type 2 Diabetes in Severely Obese Adolescents. JAMA pediatrics, 2018.PMID 29532078
- [7]Vos MB, Abrams SH, Barlow SE NASPGHAN Clinical Practice Guideline for the Diagnosis and Treatment of Nonalcoholic Fatty Liver Disease in Children. Journal of pediatric gastroenterology and nutrition, 2017.PMID 28107283
- [13]Weghuber D, Barrett T, Barrientos-Pérez M, et al. Once-Weekly Semaglutide in Adolescents with Obesity. New England Journal of Medicine, 2022.PMID 36322838