In 2007, the expert committee on childhood obesity presented a chronic care model approach that emphasized the importance of healthy dietary habits and physical activity from early childhood and a graded treatment approach based on child and family risk factors. The results of these recommendations were analyzed in data from the 2006-2009 National Ambulatory Medical Care Survey and National Hospital Ambulatory Care Survey. This survey used data from outpatient departments to examine frequencies of diet and nutrition and exercise counseling during well-child visits by children ages 2 to 18. The analysis showed that only 37 percent and 22 percent of all patients in 2006 and 2007 and 33 percent and 18 percent of all patients in 2008 and 2009 were provided with diet and nutrition and exercise counseling, respectively. Furthermore, socioeconomically disadvantaged children received counseling less frequently after the recommendations were made. Approaches are needed to improve delivery of obesity preventive care for children, regardless of socioeconomic background.

Glucagon-like peptide-1 (GLP-1) is an incretin hormone that is released in response to food intake. Liraglutide is a GLP-1 analog that is administered by once-daily injections for the treatment of type 2 diabetes (at doses up to 1.8 milligrams (mg); Victoza); however, liraglutide 3.0 mg is currently under development for chronic weight management. The effects of liraglutide 1.8 mg and 3.0 mg on gastric emptying, glycemic parameters, appetite and energy metabolism in non-diabetic adults affected by obesity was examined in a 5-week trial. The study found that gastric emptying was not different for liraglutide 1.8 mg and 3.0 mg during the initial five hours and for liraglutide versus placebo; however, there were reductions in 1-hour gastric emptying of 23 percent with liraglutide 3.0 mg and 13 percent with 1.8 mg versus placebo. Liraglutide doses similarly increased mean satiety and fullness ratings, reduced hunger and prospective food consumption and decreased ad libitum energy intake. Liraglutide 3.0 mg improved postprandial glycemia to a greater extent than liraglutide 1.8 mg. Liraglutide-induced weight loss appears to be mediated by reduced appetite and energy intake with little effect on increasing energy expenditure.