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Table 1 Recommendations from clinical practice guidelines compared and contrasted with HCP practices

From: Health care providers’ weight management practices for adolescent obesity and alignment with clinical practice guidelines: a multi-centre, qualitative study

CPG Recommendations HCP Practices Theme
4.1 We recommend that clinicians prescribe and support intensive, age-appropriate, culturally sensitive, family-centered lifestyle modifications (dietary, physical activity, behavioral) to promote a decrease in BMI. (1|  O)4.1 HCPs prescribed and supported age-appropriate, culturally sensitive, family-centered lifestyle modifications. Personalize weight management
HCPs encouraged adolescents to adopt healthy lifestyle behaviors irrespective of weight loss and defined ‘success’ based on improved health. Discuss realistic expectations regarding weight management
4.5 We suggest that the health care team identify maladaptive rearing patterns related to diet and activity and educate families about healthy food and exercise habits. (2|  OOO) HCPs probed for and addressed individual, interpersonal, and environmental issues (if applicable) experienced by parents and adolescents, including lifestyle practices related to diet and activity. Personalize weight management
4.6 We suggest that the health care team probe for and diagnose unhealthy intrafamily communication patterns and support rearing patterns that seek to enhance the child’s or adolescent’s self-esteem. (2|  OOO)4.6 HCPs addressed unhealthy communication patterns with families to clarify expectations of each member in their weight management efforts. Discuss realistic expectations regarding weight management
HCPs promoted positive self-image and acceptance in adolescents directly to help alleviate weight bias concerns and reduce stigma. Exhibit non-biased attitudes and practices
4.7 We suggest that the health care team evaluate for psychosocial comorbidities and prescribe assessment and counseling when psychosocial problems are suspected. (2|  OOO) HCPs probed for and addressed individual and interpersonal issues experienced by parents and adolescents, including psychosocial concerns. Personalize weight management
HCPs had discussions with adolescents and parents about treatment expectations and timelines at the point when they enrolled in weight management as well as during their course of treatment. Discuss realistic expectations regarding weight management
  1. Strong recommendations use the phrase “we recommend” and the number 1. Weak recommendations use the phrase “we suggest” and the number 2. Cross-filled circles indicate the quality of the evidence, such that OOO denotes very low quality evidence and O, moderate quality