Table 7.

Primary care pediatricians’ responsibilities

Conditions	Responsabilities
Risk factors: Prenatal life: first-degree familiarity for obesity, low socioeconomic status; Neonatal life: small for gestational age, or macrosomic infant; Postnatal life: no breastfeeding, early complementary feeding, excessive weight gain in the first two years of life, early adiposity rebound	Monitoring the child’s weight and length linear growth Educating to a balanced diet and healthy lifestyle since the earliest years of life Assuring appropriate timing of complementary feeding
Children and adolescents with overweight or moderate, uncomplicated obesity	Early identification of children’s excess weight Promoting parental awareness of children’s excess weight Motivating and supporting the family to change, possibly involving other professionals trained in childhood obesity
Severe obesity or psychological co-morbidity, or additional risk factors, or biochemical alterations, or treatment failure within 4–6 months	Identification of severe obesity Promoting parental awareness of children’s excess weight Motivating and supporting the family to more intensive levels of care
Suspicion of secondary obesity	Referral to specialized centers