# Pediatric Obesity — GCMD Library living collection

Everything in the library about pediatric obesity — built automatically from dossiers that name it.

Updated: n/a · 9 episodes · 170 cited statements

## Episodes
### Fundamentals
- [Welcome & Introduction: Pediatric Obesity 2017](https://library.globalcastmd.com/watch/welcome-introduction-pediatric-obesity-2017-363) — video · 3:14 · [machine version](https://library.globalcastmd.com/watch/welcome-introduction-pediatric-obesity-2017-363.md)
- [Social Determinants of Health: Pediatric Obesity 2017](https://library.globalcastmd.com/watch/social-determinants-of-health-pediatric-obesity-2017-364) — video · 42:31 · [machine version](https://library.globalcastmd.com/watch/social-determinants-of-health-pediatric-obesity-2017-364.md)

### Medical Management
- [Pharmacology: Pediatric Obesity 2017](https://library.globalcastmd.com/watch/pharmacology-pediatric-obesity-2017-366) — video · 45:08 · [machine version](https://library.globalcastmd.com/watch/pharmacology-pediatric-obesity-2017-366.md)

### Evidence & Research
- [Psychology Journal Club: Pediatric Obesity 2017](https://library.globalcastmd.com/watch/psychology-journal-club-pediatric-obesity-2017-368) — video · 27:51 · [machine version](https://library.globalcastmd.com/watch/psychology-journal-club-pediatric-obesity-2017-368.md)
- [Nutrition Journal Club: Pediatric Obesity 2017](https://library.globalcastmd.com/watch/nutrition-journal-club-pediatric-obesity-2017-369) — video · 31:44 · [machine version](https://library.globalcastmd.com/watch/nutrition-journal-club-pediatric-obesity-2017-369.md)
- [Exercise Journal Club: Pediatric Obesity 2017](https://library.globalcastmd.com/watch/exercise-journal-club-pediatric-obesity-2017-370) — video · 25:58 · [machine version](https://library.globalcastmd.com/watch/exercise-journal-club-pediatric-obesity-2017-370.md)

### In-Depth Reviews
- [Rapid Fire and Conclusion: Pediatric Obesity 2017](https://library.globalcastmd.com/watch/rapid-fire-and-conclusion-pediatric-obesity-2017-373) — video · 23:37 · [machine version](https://library.globalcastmd.com/watch/rapid-fire-and-conclusion-pediatric-obesity-2017-373.md)
- [Pediatric Obesity Is a Disease: Treatment, Medications, Surgery & Equity in Care with Dr. Justin Ryder](https://library.globalcastmd.com/watch/pediatric-obesity-is-a-disease-treatment-medications-surgery-equity-in-care-with-dr-justin-ryder-11602) — video · 6:48 · [machine version](https://library.globalcastmd.com/watch/pediatric-obesity-is-a-disease-treatment-medications-surgery-equity-in-care-with-dr-justin-ryder-11602.md)

### Emerging & Future Directions
- [Public Policies to Address Obesity: Pediatric Obesity 2017](https://library.globalcastmd.com/watch/public-policies-to-address-obesity-pediatric-obesity-2017-365) — video · 46:10 · [machine version](https://library.globalcastmd.com/watch/public-policies-to-address-obesity-pediatric-obesity-2017-365.md)

## Chapters
- [0:00](https://library.globalcastmd.com/watch/welcome-introduction-pediatric-obesity-2017-363?t=0) Welcome and Introduction to Pediatric Obesity 2017 Global Cast (Ep 1)
- [0:00](https://library.globalcastmd.com/watch/social-determinants-of-health-pediatric-obesity-2017-364?t=0) Introduction of Dr. Chris Bowling (Ep 2)
- [0:49](https://library.globalcastmd.com/watch/social-determinants-of-health-pediatric-obesity-2017-364?t=49) Geographic clustering of mortality and disease burden (Ep 2)
- [7:00](https://library.globalcastmd.com/watch/social-determinants-of-health-pediatric-obesity-2017-364?t=420) Introduction to adverse childhood experiences (ACEs) and toxic stress (Ep 2)
- [15:00](https://library.globalcastmd.com/watch/social-determinants-of-health-pediatric-obesity-2017-364?t=900) Physiologic mechanisms of toxic stress (Ep 2)
- [19:40](https://library.globalcastmd.com/watch/social-determinants-of-health-pediatric-obesity-2017-364?t=1180) Screening for ACEs in pediatric practice: barriers and tools (Ep 2)
- [30:00](https://library.globalcastmd.com/watch/social-determinants-of-health-pediatric-obesity-2017-364?t=1800) Implications for obesity care and community interventions (Ep 2)
- [34:34](https://library.globalcastmd.com/watch/social-determinants-of-health-pediatric-obesity-2017-364?t=2074) Q&A: Implementation strategies and clinic experiences (Ep 2)
- [0:00](https://library.globalcastmd.com/watch/public-policies-to-address-obesity-pediatric-obesity-2017-365?t=0) Introduction of Dr. Kelly Brownell (Ep 3)
- [1:16](https://library.globalcastmd.com/watch/public-policies-to-address-obesity-pediatric-obesity-2017-365?t=76) Conceptual Framework: Individual vs. Environmental Approaches (Ep 3)
- [7:00](https://library.globalcastmd.com/watch/public-policies-to-address-obesity-pediatric-obesity-2017-365?t=420) The Power of Defaults: Pension Plans and Organ Donation (Ep 3)
- [15:00](https://library.globalcastmd.com/watch/public-policies-to-address-obesity-pediatric-obesity-2017-365?t=900) Toxic Food Defaults and Personal Responsibility (Ep 3)
- [20:00](https://library.globalcastmd.com/watch/public-policies-to-address-obesity-pediatric-obesity-2017-365?t=1200) Bridging Research and Policy: The Dropped Baton Problem (Ep 3)
- [25:00](https://library.globalcastmd.com/watch/public-policies-to-address-obesity-pediatric-obesity-2017-365?t=1500) Sugar-Sweetened Beverage Taxes: Case Study and Implementation (Ep 3)
- [32:58](https://library.globalcastmd.com/watch/public-policies-to-address-obesity-pediatric-obesity-2017-365?t=1978) Q&A: Tax Revenue, Food Subsidies, and School Nutrition (Ep 3)
- [38:28](https://library.globalcastmd.com/watch/public-policies-to-address-obesity-pediatric-obesity-2017-365?t=2308) Q&A: SNAP Benefits, Small Business Concerns, and Closing (Ep 3)
- [0:00](https://library.globalcastmd.com/watch/pharmacology-pediatric-obesity-2017-366?t=0) Introduction and Speaker Presentation (Ep 4)
- [2:09](https://library.globalcastmd.com/watch/pharmacology-pediatric-obesity-2017-366?t=129) Why Consider Pharmacotherapy for Pediatric Obesity (Ep 4)
- [11:20](https://library.globalcastmd.com/watch/pharmacology-pediatric-obesity-2017-366?t=680) Limitations of Lifestyle Modification Therapy (Ep 4)
- [18:00](https://library.globalcastmd.com/watch/pharmacology-pediatric-obesity-2017-366?t=1080) Biological Mechanisms of Obesity and Weight Regain (Ep 4)
- [25:00](https://library.globalcastmd.com/watch/pharmacology-pediatric-obesity-2017-366?t=1500) FDA-Approved Medications: Orlistat and Phentermine (Ep 4)
- [32:00](https://library.globalcastmd.com/watch/pharmacology-pediatric-obesity-2017-366?t=1920) Off-Label Medications and Future Directions (Ep 4)
- [37:50](https://library.globalcastmd.com/watch/pharmacology-pediatric-obesity-2017-366?t=2270) Q&A: Long-term Use, Insurance Coverage, and Clinical Practice (Ep 4)
- [0:00](https://library.globalcastmd.com/watch/psychology-journal-club-pediatric-obesity-2017-368?t=0) Introduction and Study Overview: Social-Emotional Problems and Obesity Risk (Ep 5)
- [2:52](https://library.globalcastmd.com/watch/psychology-journal-club-pediatric-obesity-2017-368?t=172) Study Rationale and Design: Risk Factors and Intervention Groups (Ep 5)
- [7:00](https://library.globalcastmd.com/watch/psychology-journal-club-pediatric-obesity-2017-368?t=420) Study Methods, Results, and Limitations (Ep 5)
- [13:45](https://library.globalcastmd.com/watch/psychology-journal-club-pediatric-obesity-2017-368?t=825) Discussion: Maternal Depression Screening and Integration of Behavioral Health (Ep 5)
- [19:00](https://library.globalcastmd.com/watch/psychology-journal-club-pediatric-obesity-2017-368?t=1140) OB-Pediatrics Coordination and Parenting Style Assessment (Ep 5)
- [22:46](https://library.globalcastmd.com/watch/psychology-journal-club-pediatric-obesity-2017-368?t=1366) Group Care Models and Alternative Delivery Strategies (Ep 5)
- [0:00](https://library.globalcastmd.com/watch/nutrition-journal-club-pediatric-obesity-2017-369?t=0) Mobile App Content Analysis and Clinical Photo Food Log Protocol (Ep 6)
- [15:08](https://library.globalcastmd.com/watch/nutrition-journal-club-pediatric-obesity-2017-369?t=908) Implementation Discussion and Barriers to Broader Adoption (Ep 6)
- [0:00](https://library.globalcastmd.com/watch/exercise-journal-club-pediatric-obesity-2017-370?t=0) Study presentation: Summer versus school-year obesity prevalence growth (Ep 7)
- [12:37](https://library.globalcastmd.com/watch/exercise-journal-club-pediatric-obesity-2017-370?t=757) Clinical approaches to summer activity planning and barriers (Ep 7)
- [18:00](https://library.globalcastmd.com/watch/exercise-journal-club-pediatric-obesity-2017-370?t=1080) ADHD medications, sleep, and weight management considerations (Ep 7)
- [0:00](https://library.globalcastmd.com/watch/rapid-fire-and-conclusion-pediatric-obesity-2017-373?t=0) Optimal BMI for Bariatric Surgery Intervention and Surgery vs. Medication Decision-Making (Ep 8)
- [8:18](https://library.globalcastmd.com/watch/rapid-fire-and-conclusion-pediatric-obesity-2017-373?t=498) Pharmacotherapy Use Patterns in Clinical Practice (Ep 8)
- [10:42](https://library.globalcastmd.com/watch/rapid-fire-and-conclusion-pediatric-obesity-2017-373?t=642) Financial Viability of Nutrition Services (Ep 8)
- [14:22](https://library.globalcastmd.com/watch/rapid-fire-and-conclusion-pediatric-obesity-2017-373?t=862) Sugar Tax Policy Debate (Ep 8)
- [16:47](https://library.globalcastmd.com/watch/rapid-fire-and-conclusion-pediatric-obesity-2017-373?t=1007) Eating Disorders in Obesity Treatment (Ep 8)
- [22:37](https://library.globalcastmd.com/watch/rapid-fire-and-conclusion-pediatric-obesity-2017-373?t=1357) Closing Remarks (Ep 8)

## Statements
Every statement is attributed, typed, and timestamped; the link is the citation.
- "BMIs in the 40s will predictably achieve post-surgical BMIs less than 30" (clinical) [Ep 8 · 0:56](https://library.globalcastmd.com/watch/rapid-fire-and-conclusion-pediatric-obesity-2017-373?t=56)
- "Earlier intervention in bariatric surgery improves quality of life for patients" (clinical) [Ep 8 · 1:49](https://library.globalcastmd.com/watch/rapid-fire-and-conclusion-pediatric-obesity-2017-373?t=109)
- "Operating at lower degrees of obesity allows moving patients into a much healthier state" (host_summary) [Ep 8 · 2:27](https://library.globalcastmd.com/watch/rapid-fire-and-conclusion-pediatric-obesity-2017-373?t=147)
- "Patients above BMI 55 have only about 14% probability of achieving BMI below 30 after surgery (data published by Tom in 2009)" (host_summary) [Ep 8 · 3:05](https://library.globalcastmd.com/watch/rapid-fire-and-conclusion-pediatric-obesity-2017-373?t=185)
- "Once BMI crosses 50 threshold, probability of mitigating risks associated with BMI 35+ becomes challenging" (clinical) [Ep 8 · 3:32](https://library.globalcastmd.com/watch/rapid-fire-and-conclusion-pediatric-obesity-2017-373?t=212)
- "Conversation about bariatric surgery should begin when BMI reaches mid-30s, especially with comorbidities" (opinion) [Ep 8 · 3:59](https://library.globalcastmd.com/watch/rapid-fire-and-conclusion-pediatric-obesity-2017-373?t=239)
- "At BMI 49, surgery may fail to get patients out of the severely obese category" (clinical) [Ep 8 · 5:34](https://library.globalcastmd.com/watch/rapid-fire-and-conclusion-pediatric-obesity-2017-373?t=334)
- "Topiramate and phentermine can be used as bridge therapy to buy time for patient maturity before surgery" (clinical) [Ep 8 · 6:27](https://library.globalcastmd.com/watch/rapid-fire-and-conclusion-pediatric-obesity-2017-373?t=387)
- "Medications can serve as bridge to surgery, primary therapeutic intervention, or post-surgical adjunct depending on patient needs" (clinical) [Ep 8 · 7:06](https://library.globalcastmd.com/watch/rapid-fire-and-conclusion-pediatric-obesity-2017-373?t=426)
- "Obesity is a heterogeneous disease requiring continuous treatment escalation based on individual patient response" (clinical) [Ep 8 · 7:56](https://library.globalcastmd.com/watch/rapid-fire-and-conclusion-pediatric-obesity-2017-373?t=476)
- "Medications should be initiated after 3-6 months in program when healthy living alone is insufficient to control disease" (guideline) [Ep 8 · 8:31](https://library.globalcastmd.com/watch/rapid-fire-and-conclusion-pediatric-obesity-2017-373?t=511)
- "Dexamphetamine has evidence base for hypothalamic obesity patients and may be needed pre- and post-surgery" (clinical) [Ep 8 · 9:15](https://library.globalcastmd.com/watch/rapid-fire-and-conclusion-pediatric-obesity-2017-373?t=555)
- "Hypothalamic obesity patients have biological drive to gain weight that defeats surgery, profoundly different from patients without brain injury" (clinical) [Ep 8 · 9:32](https://library.globalcastmd.com/watch/rapid-fire-and-conclusion-pediatric-obesity-2017-373?t=572)
- "Private insurers are limiting dietitian visits to 3 per year, inadequate for chronic disease management" (clinical) [Ep 8 · 13:36](https://library.globalcastmd.com/watch/rapid-fire-and-conclusion-pediatric-obesity-2017-373?t=816)
- "Sugar taxation decreases consumption and generates revenue (data shown by Gellibrano)" (host_summary) [Ep 8 · 15:24](https://library.globalcastmd.com/watch/rapid-fire-and-conclusion-pediatric-obesity-2017-373?t=924)
- "Taxing specific products like sugar will not have desired impact because obesity is not caused by sugar per se" (opinion) [Ep 8 · 15:08](https://library.globalcastmd.com/watch/rapid-fire-and-conclusion-pediatric-obesity-2017-373?t=908)
- "Most obese patients meet objective criteria for binge eating disorder when assessed with questionnaires, even without formal diagnosis" (epidemiological) [Ep 8 · 19:53](https://library.globalcastmd.com/watch/rapid-fire-and-conclusion-pediatric-obesity-2017-373?t=1193)
- "Bariatric surgery demonstrates good resolution of binge eating disorder symptoms in adult literature (Jim Mitchell's work in LABS consortium)" (host_summary) [Ep 8 · 20:20](https://library.globalcastmd.com/watch/rapid-fire-and-conclusion-pediatric-obesity-2017-373?t=1220)
- "Surgery is effective at extinguishing binge eating behaviors" (clinical) [Ep 8 · 20:49](https://library.globalcastmd.com/watch/rapid-fire-and-conclusion-pediatric-obesity-2017-373?t=1249)
- "Prior binge eating disorder diagnosis may pose higher risk for relapse or weight regain long-term after surgery" (clinical) [Ep 8 · 21:03](https://library.globalcastmd.com/watch/rapid-fire-and-conclusion-pediatric-obesity-2017-373?t=1263)
- "Rate of true diagnosable binge eating disorder in obese pediatric patients is under 5% when screened with diagnostic criteria" (epidemiological) [Ep 8 · 21:33](https://library.globalcastmd.com/watch/rapid-fire-and-conclusion-pediatric-obesity-2017-373?t=1293)
- "Disordered eating (restricting during day, overeating in evening) is present in many obese patients even without formal eating disorder diagnosis" (clinical) [Ep 8 · 21:18](https://library.globalcastmd.com/watch/rapid-fire-and-conclusion-pediatric-obesity-2017-373?t=1278)
- "Patients who develop fear of eating and severe restriction should be referred to eating disorders programs" (guideline) [Ep 8 · 21:51](https://library.globalcastmd.com/watch/rapid-fire-and-conclusion-pediatric-obesity-2017-373?t=1311)
- "Disordered eating applies to nearly every obese patient, involving feelings and emotions around eating, food, and restricting, even without meeting DSM criteria" (clinical) [Ep 8 · 22:20](https://library.globalcastmd.com/watch/rapid-fire-and-conclusion-pediatric-obesity-2017-373?t=1340)
- "Obesity is a disease impacted by behavior and represents a multifactorial disease impacted by a robust gene-environment interaction." — Justin Ryder (clinical) [Ep 9 · 0:32](https://library.globalcastmd.com/watch/pediatric-obesity-is-a-disease-treatment-medications-surgery-equity-in-care-with-dr-justin-ryder-11602?t=32)
- "Obesity is influenced by numerous factors including genetics, epigenetics, appetite and satiety hormone dysregulation, stress, economics, adverse life experiences, and environmental factors like calorically dense foods and sedentary lifestyles." — Justin Ryder (clinical) [Ep 9 · 0:44](https://library.globalcastmd.com/watch/pediatric-obesity-is-a-disease-treatment-medications-surgery-equity-in-care-with-dr-justin-ryder-11602?t=44)
- "Historically, about 90% of efforts over the past 50 years have been on prevention of childhood obesity." — Justin Ryder (epidemiological) [Ep 9 · 1:08](https://library.globalcastmd.com/watch/pediatric-obesity-is-a-disease-treatment-medications-surgery-equity-in-care-with-dr-justin-ryder-11602?t=68)
- "The new AAP clinical practice guidelines clearly state that obesity is a disease." — Justin Ryder (guideline) [Ep 9 · 1:15](https://library.globalcastmd.com/watch/pediatric-obesity-is-a-disease-treatment-medications-surgery-equity-in-care-with-dr-justin-ryder-11602?t=75)
- "Treatment should be offered to all children above the 85th percentile, and there should be no more watchful waiting." — Justin Ryder (guideline) [Ep 9 · 1:25](https://library.globalcastmd.com/watch/pediatric-obesity-is-a-disease-treatment-medications-surgery-equity-in-care-with-dr-justin-ryder-11602?t=85)
- "The guidelines describe a non-linear continuum of care starting with intensive health, behavior, and lifestyle treatment involving more than 26 contact hours over a 3 to 12-month period." — Justin Ryder (guideline) [Ep 9 · 1:41](https://library.globalcastmd.com/watch/pediatric-obesity-is-a-disease-treatment-medications-surgery-equity-in-care-with-dr-justin-ryder-11602?t=101)
- "Pharmacotherapy is FDA labeled for adolescents above the age of 12." — Justin Ryder (guideline) [Ep 9 · 1:55](https://library.globalcastmd.com/watch/pediatric-obesity-is-a-disease-treatment-medications-surgery-equity-in-care-with-dr-justin-ryder-11602?t=115)
- "Currently, there are 5 medications that are FDA approved for the treatment of adolescents with obesity." — Justin Ryder (clinical) [Ep 9 · 2:02](https://library.globalcastmd.com/watch/pediatric-obesity-is-a-disease-treatment-medications-surgery-equity-in-care-with-dr-justin-ryder-11602?t=122)
- "Bariatric surgery should be considered for those over the age of 13 years old with a BMI 1.2 times the 95th percentile." — Justin Ryder (guideline) [Ep 9 · 2:08](https://library.globalcastmd.com/watch/pediatric-obesity-is-a-disease-treatment-medications-surgery-equity-in-care-with-dr-justin-ryder-11602?t=128)
- "Wegovy, a GLP-1 receptor agonist, causes about 17% weight loss and is FDA approved in adolescents." — Justin Ryder (clinical) [Ep 9 · 2:29](https://library.globalcastmd.com/watch/pediatric-obesity-is-a-disease-treatment-medications-surgery-equity-in-care-with-dr-justin-ryder-11602?t=149)
- "Data in adults on tirzepatide shows significant change in body weight compared to placebo." — Justin Ryder (clinical) [Ep 9 · 2:44](https://library.globalcastmd.com/watch/pediatric-obesity-is-a-disease-treatment-medications-surgery-equity-in-care-with-dr-justin-ryder-11602?t=164)
- "Oral GLP-1 medications are on the way in a few short years." — Justin Ryder (clinical) [Ep 9 · 2:51](https://library.globalcastmd.com/watch/pediatric-obesity-is-a-disease-treatment-medications-surgery-equity-in-care-with-dr-justin-ryder-11602?t=171)
- "Bariatric surgery studies show sustained weight loss in both adults and adolescent cohorts over several years." — Justin Ryder (clinical) [Ep 9 · 2:51](https://library.globalcastmd.com/watch/pediatric-obesity-is-a-disease-treatment-medications-surgery-equity-in-care-with-dr-justin-ryder-11602?t=171)
- "There is no difference between Roux-en-Y gastric bypass and vertical sleeve gastrectomy in terms of percent BMI change from baseline over a 10-year period." — Justin Ryder (clinical) [Ep 9 · 3:03](https://library.globalcastmd.com/watch/pediatric-obesity-is-a-disease-treatment-medications-surgery-equity-in-care-with-dr-justin-ryder-11602?t=183)
- "There is significant heterogeneity in response to bariatric surgery, and weight regain is a significant problem." — Justin Ryder (clinical) [Ep 9 · 3:18](https://library.globalcastmd.com/watch/pediatric-obesity-is-a-disease-treatment-medications-surgery-equity-in-care-with-dr-justin-ryder-11602?t=198)
- "Bariatric surgery produces substantial improvements in conditions that commonly occur with obesity, like hypertension, diabetes, and high lipids." — Justin Ryder (clinical) [Ep 9 · 3:24](https://library.globalcastmd.com/watch/pediatric-obesity-is-a-disease-treatment-medications-surgery-equity-in-care-with-dr-justin-ryder-11602?t=204)
- "Weight regain is driven by a complex interplay between behaviors like physical activity and energy intake, and biological factors like energy expenditure and appetite and satiety hormones that regulate how full you feel." — Justin Ryder (clinical) [Ep 9 · 3:40](https://library.globalcastmd.com/watch/pediatric-obesity-is-a-disease-treatment-medications-surgery-equity-in-care-with-dr-justin-ryder-11602?t=220)
- "Weight regain factors are all influenced by genetics and the environment, including puberty, race, and socioeconomic status." — Justin Ryder (clinical) [Ep 9 · 3:56](https://library.globalcastmd.com/watch/pediatric-obesity-is-a-disease-treatment-medications-surgery-equity-in-care-with-dr-justin-ryder-11602?t=236)
- "It is much easier to lose weight than to keep it off, which is demonstrated across many studies." — Justin Ryder (clinical) [Ep 9 · 4:03](https://library.globalcastmd.com/watch/pediatric-obesity-is-a-disease-treatment-medications-surgery-equity-in-care-with-dr-justin-ryder-11602?t=243)
- "Metabolic dysfunction-associated steatotic liver disease (MASLD) is the most prevalent pediatric liver disease." — Justin Ryder (epidemiological) [Ep 9 · 4:22](https://library.globalcastmd.com/watch/pediatric-obesity-is-a-disease-treatment-medications-surgery-equity-in-care-with-dr-justin-ryder-11602?t=262)
- "Obesity is a significant risk factor for MASLD." — Justin Ryder (clinical) [Ep 9 · 4:31](https://library.globalcastmd.com/watch/pediatric-obesity-is-a-disease-treatment-medications-surgery-equity-in-care-with-dr-justin-ryder-11602?t=271)
- "About 20% of youth in the United States have obesity, which is roughly 15 million children." — Justin Ryder (epidemiological) [Ep 9 · 4:34](https://library.globalcastmd.com/watch/pediatric-obesity-is-a-disease-treatment-medications-surgery-equity-in-care-with-dr-justin-ryder-11602?t=274)
- "Approximately 5 million children have both obesity and MASLD." — Justin Ryder (epidemiological) [Ep 9 · 4:40](https://library.globalcastmd.com/watch/pediatric-obesity-is-a-disease-treatment-medications-surgery-equity-in-care-with-dr-justin-ryder-11602?t=280)
- "Between 250,000 and 1 million children with obesity and MASLD will progress to cirrhosis and needing a liver transplant or having hepatocellular carcinoma." — Justin Ryder (epidemiological) [Ep 9 · 4:45](https://library.globalcastmd.com/watch/pediatric-obesity-is-a-disease-treatment-medications-surgery-equity-in-care-with-dr-justin-ryder-11602?t=285)
- "There are racial and ethnic differences in MASLD prevalence." — Justin Ryder (epidemiological) [Ep 9 · 4:56](https://library.globalcastmd.com/watch/pediatric-obesity-is-a-disease-treatment-medications-surgery-equity-in-care-with-dr-justin-ryder-11602?t=296)
- "Obesity affects at least 35% of adults and 20% of children in Illinois alone." — Justin Ryder (epidemiological) [Ep 9 · 5:09](https://library.globalcastmd.com/watch/pediatric-obesity-is-a-disease-treatment-medications-surgery-equity-in-care-with-dr-justin-ryder-11602?t=309)
- "The rates of severe forms of obesity are only increasing." — Justin Ryder (epidemiological) [Ep 9 · 5:09](https://library.globalcastmd.com/watch/pediatric-obesity-is-a-disease-treatment-medications-surgery-equity-in-care-with-dr-justin-ryder-11602?t=309)
- "Obesity significantly increases the risk of long-term health problems and early death." — Justin Ryder (clinical) [Ep 9 · 5:19](https://library.globalcastmd.com/watch/pediatric-obesity-is-a-disease-treatment-medications-surgery-equity-in-care-with-dr-justin-ryder-11602?t=319)
- "The economic impact of obesity is substantial, with reductions in GDP and increases in state spending." — Justin Ryder (epidemiological) [Ep 9 · 5:23](https://library.globalcastmd.com/watch/pediatric-obesity-is-a-disease-treatment-medications-surgery-equity-in-care-with-dr-justin-ryder-11602?t=323)
- "Obesity is a disease driven by biology and it is no one's fault." — Justin Ryder (opinion) [Ep 9 · 5:30](https://library.globalcastmd.com/watch/pediatric-obesity-is-a-disease-treatment-medications-surgery-equity-in-care-with-dr-justin-ryder-11602?t=330)
- "Access to effective obesity medications is a health equity issue." — Justin Ryder (opinion) [Ep 9 · 5:37](https://library.globalcastmd.com/watch/pediatric-obesity-is-a-disease-treatment-medications-surgery-equity-in-care-with-dr-justin-ryder-11602?t=337)
- "Obesity disproportionately affects people of color and those living in poverty." — Justin Ryder (epidemiological) [Ep 9 · 5:41](https://library.globalcastmd.com/watch/pediatric-obesity-is-a-disease-treatment-medications-surgery-equity-in-care-with-dr-justin-ryder-11602?t=341)
- "Organizations like the Stop Obesity Alliance are working to analyze how states are covering obesity medications in Medicaid programs, and there is significant variation across the country." — Justin Ryder (clinical) [Ep 9 · 5:49](https://library.globalcastmd.com/watch/pediatric-obesity-is-a-disease-treatment-medications-surgery-equity-in-care-with-dr-justin-ryder-11602?t=349)
- "This is the fifth year of the pediatric obesity global cast hosted by Children's Healthcare of Atlanta." — Mark Wolco (clinical) [Ep 1 · 0:00](https://library.globalcastmd.com/watch/welcome-introduction-pediatric-obesity-2017-363?t=0)
- "Dr. Mark Wolco is the surgeon-in-chief at Children's Healthcare of Atlanta and part of the Strong for Life program as the bariatric surgeon." — Mark Wolco (clinical) [Ep 1 · 0:00](https://library.globalcastmd.com/watch/welcome-introduction-pediatric-obesity-2017-363?t=0)
- "Dr. Stephanie Walsh is an associate professor of surgery and pediatrics and the medical director of wellness in the Strong for Life clinic at Children's Healthcare of Atlanta." — Mark Wolco (clinical) [Ep 1 · 0:50](https://library.globalcastmd.com/watch/welcome-introduction-pediatric-obesity-2017-363?t=50)
- "Dr. Chris Bowling is a private practice pediatrician in Kentucky and the chair of the section on obesity of the American Academy of Pediatrics." — Mark Wolco (clinical) [Ep 1 · 1:40](https://library.globalcastmd.com/watch/welcome-introduction-pediatric-obesity-2017-363?t=100)
- "Age-standardized mortality rates show clustering of respiratory disease deaths in eastern Kentucky and southern West Virginia coal-mining areas." — Chris Bowling (epidemiological) [Ep 2 · 4:00](https://library.globalcastmd.com/watch/social-determinants-of-health-pediatric-obesity-2017-364?t=240)
- "Cardiovascular disease mortality is very high in the Mississippi Delta region (Arkansas, Tennessee, Mississippi, Louisiana border) and in Appalachia." — Chris Bowling (epidemiological) [Ep 2 · 4:40](https://library.globalcastmd.com/watch/social-determinants-of-health-pediatric-obesity-2017-364?t=280)
- "Eastern Kentucky and southern West Virginia are the epicenter of the current heroin outbreak, with staggering rates." — Chris Bowling (epidemiological) [Ep 2 · 5:40](https://library.globalcastmd.com/watch/social-determinants-of-health-pediatric-obesity-2017-364?t=340)
- "The heroin epidemic in the Ohio River Valley resulted from a distribution network encountering a population primed by the prescription drug epidemic." — Chris Bowling (opinion) [Ep 2 · 6:10](https://library.globalcastmd.com/watch/social-determinants-of-health-pediatric-obesity-2017-364?t=370)
- "Cancer mortality rates are very high in the Mississippi Delta and Appalachia, possibly tied to chronic respiratory illness." — Chris Bowling (epidemiological) [Ep 2 · 6:40](https://library.globalcastmd.com/watch/social-determinants-of-health-pediatric-obesity-2017-364?t=400)
- "Areas with high mortality from multiple diseases (respiratory, cardiovascular, cancer, infections) have a distribution similar to areas affected by pediatric obesity." — Chris Bowling (epidemiological) [Ep 2 · 7:30](https://library.globalcastmd.com/watch/social-determinants-of-health-pediatric-obesity-2017-364?t=450)
- "Common infections (pneumonia, diarrhea) show geographic clustering tied to socioeconomic status, similar to obesity and oral health." — Chris Bowling (epidemiological) [Ep 2 · 8:00](https://library.globalcastmd.com/watch/social-determinants-of-health-pediatric-obesity-2017-364?t=480)
- "The ACEs (adverse childhood experiences) study was developed in 1997 by Felitti and Anda in San Diego, starting as a dropout study from an obesity treatment program." — Chris Bowling (clinical) [Ep 2 · 10:50](https://library.globalcastmd.com/watch/social-determinants-of-health-pediatric-obesity-2017-364?t=650)
- "Patients succeeding in the obesity program were dropping out at rates equal to those struggling, prompting investigation into other life factors." — Chris Bowling (clinical) [Ep 2 · 11:30](https://library.globalcastmd.com/watch/social-determinants-of-health-pediatric-obesity-2017-364?t=690)
- "The ten adverse childhood experiences (ACEs) are: physical abuse, sexual abuse, emotional abuse, physical neglect, emotional neglect, mother treated violently, household substance abuse, household mental illness, parental separation/divorce, and incarcerated household member." — Chris Bowling (clinical) [Ep 2 · 14:10](https://library.globalcastmd.com/watch/social-determinants-of-health-pediatric-obesity-2017-364?t=850)
- "In families with ACEs, there are increases in smoking, substance abuse, obesity, diabetes, heart disease, stroke, and cancer." — Chris Bowling (epidemiological) [Ep 2 · 15:50](https://library.globalcastmd.com/watch/social-determinants-of-health-pediatric-obesity-2017-364?t=950)
- "Even when controlling for behavioral factors (obesity, smoking, substance abuse), children exposed to ACEs still had higher rates of diabetes, heart disease, stroke, and cancer." — Chris Bowling (epidemiological) [Ep 2 · 16:20](https://library.globalcastmd.com/watch/social-determinants-of-health-pediatric-obesity-2017-364?t=980)
- "Children exposed to ACEs had shortened life expectancy even when controlling for behavioral risk factors." — Chris Bowling (epidemiological) [Ep 2 · 17:00](https://library.globalcastmd.com/watch/social-determinants-of-health-pediatric-obesity-2017-364?t=1020)
- "In the ACEs study population, 67% of families reported at least one ACE, 40% had two or more, and 12.5% (1 in 8) had four or more." — Chris Bowling (epidemiological) [Ep 2 · 17:30](https://library.globalcastmd.com/watch/social-determinants-of-health-pediatric-obesity-2017-364?t=1050)
- "The effects of multiple ACEs are more than additive—they are almost multiplicative, with profound health impacts as the number of ACEs increases." — Chris Bowling (epidemiological) [Ep 2 · 18:10](https://library.globalcastmd.com/watch/social-determinants-of-health-pediatric-obesity-2017-364?t=1090)
- "Chronic activation of the fight-or-flight response—persistent elevation of epinephrine, cortisol, norepinephrine—has real physiologic consequences over a lifetime." — Chris Bowling (clinical) [Ep 2 · 19:40](https://library.globalcastmd.com/watch/social-determinants-of-health-pediatric-obesity-2017-364?t=1180)
- "Toxic stress causes neuronal desensitization and altered neuronal response." — Chris Bowling (clinical) [Ep 2 · 20:40](https://library.globalcastmd.com/watch/social-determinants-of-health-pediatric-obesity-2017-364?t=1240)
- "Toxic stress affects the hypothalamic-pituitary-adrenal axis and other parts of the endocrine system." — Chris Bowling (clinical) [Ep 2 · 21:00](https://library.globalcastmd.com/watch/social-determinants-of-health-pediatric-obesity-2017-364?t=1260)
- "Overstimulation by norepinephrine, epinephrine, and cortisol may affect leptin resistance and insulin resistance in children with obesity." — Chris Bowling (opinion) [Ep 2 · 21:20](https://library.globalcastmd.com/watch/social-determinants-of-health-pediatric-obesity-2017-364?t=1280)
- "Toxic stress decreases the ability to fight off infection and changes immune modulation." — Chris Bowling (clinical) [Ep 2 · 21:50](https://library.globalcastmd.com/watch/social-determinants-of-health-pediatric-obesity-2017-364?t=1310)
- "Living in a stressful situation changes gene expression through epigenetic mechanisms—methylation and histone modification—that can result in adverse health outcomes." — Chris Bowling (clinical) [Ep 2 · 22:30](https://library.globalcastmd.com/watch/social-determinants-of-health-pediatric-obesity-2017-364?t=1350)
- "Epigenetic changes from toxic stress have profound impacts on development, aging, mental health, diabetes, and cancer." — Chris Bowling (clinical) [Ep 2 · 23:20](https://library.globalcastmd.com/watch/social-determinants-of-health-pediatric-obesity-2017-364?t=1400)
- "Social determinants of health can be used as proxy questions to screen for adverse childhood experiences and categorize families by risk." — Chris Bowling (clinical) [Ep 2 · 24:10](https://library.globalcastmd.com/watch/social-determinants-of-health-pediatric-obesity-2017-364?t=1450)
- "Barriers to ACEs screening in pediatric practice include provider concerns about parent pushback, time constraints, lack of resources to address identified problems, and poor reimbursement." — Chris Bowling (opinion) [Ep 2 · 25:00](https://library.globalcastmd.com/watch/social-determinants-of-health-pediatric-obesity-2017-364?t=1500)
- "The SEEK (Safe Environment for Every Kid) screening tool from the University of Maryland is used at 1-month, 9-month, 2-year, and 3-year well-child visits in Bowling's practice." — Chris Bowling (clinical) [Ep 2 · 28:20](https://library.globalcastmd.com/watch/social-determinants-of-health-pediatric-obesity-2017-364?t=1700)
- "In Bowling's suburban practice, 10–15% of the population screens positive for adverse childhood experiences on the SEEK tool at a single point in time." — Chris Bowling (epidemiological) [Ep 2 · 32:30](https://library.globalcastmd.com/watch/social-determinants-of-health-pediatric-obesity-2017-364?t=1950)
- "The original ACEs study population was 70% white, 70% college-educated, and 100% insured, demonstrating that ACEs are not limited to low-income populations." — Chris Bowling (epidemiological) [Ep 2 · 31:40](https://library.globalcastmd.com/watch/social-determinants-of-health-pediatric-obesity-2017-364?t=1900)
- "Food insecurity is directly connected to adverse childhood experiences and is one of the more commonly answered questions on the SEEK questionnaire." — Chris Bowling (clinical) [Ep 2 · 30:00](https://library.globalcastmd.com/watch/social-determinants-of-health-pediatric-obesity-2017-364?t=1800)
- "Unstable or variable housing impacts the ability to maintain healthy food environments and to maintain contact with families in obesity care." — Chris Bowling (opinion) [Ep 2 · 30:40](https://library.globalcastmd.com/watch/social-determinants-of-health-pediatric-obesity-2017-364?t=1840)
- "Nadine Burke Harris is a developmental specialist at UCLA who gave a 16-minute TEDMed talk on toxic stress and ACEs." — Chris Bowling (clinical) [Ep 2 · 33:40](https://library.globalcastmd.com/watch/social-determinants-of-health-pediatric-obesity-2017-364?t=2020)
- "Bowling's practice partners with Beech Acres Parenting Center, which provides an in-office parenting specialist to counsel families, connect them with resources, and teach behavioral techniques." — Chris Bowling (clinical) [Ep 2 · 27:00](https://library.globalcastmd.com/watch/social-determinants-of-health-pediatric-obesity-2017-364?t=1620)
- "Motivational interviewing skills are useful for asking ACEs screening questions in a non-threatening way and getting to the root of family issues." — Chris Bowling (opinion) [Ep 2 · 37:40](https://library.globalcastmd.com/watch/social-determinants-of-health-pediatric-obesity-2017-364?t=2260)
- "In one clinic, 25% of families screened positive for food insecurity, making it difficult to discuss weight management when families cannot put food on the table." (epidemiological) [Ep 2 · 36:00](https://library.globalcastmd.com/watch/social-determinants-of-health-pediatric-obesity-2017-364?t=2160)
- "Primary care providers in Maine feel supported in asking ACEs screening questions and have connected with behavioral health colleagues for referrals." — Tory (clinical) [Ep 2 · 36:40](https://library.globalcastmd.com/watch/social-determinants-of-health-pediatric-obesity-2017-364?t=2200)
- "Most families accept ACEs screening questions without resistance or pushback once the rationale is explained by the nurse." — Sheel (clinical) [Ep 2 · 38:40](https://library.globalcastmd.com/watch/social-determinants-of-health-pediatric-obesity-2017-364?t=2320)
- "When people consume calories in liquid form, they tend not to feel as full and tend to overconsume compared to consuming the same number of calories in solid form." — Kelly Brownell (clinical) [Ep 3 · 25:00](https://library.globalcastmd.com/watch/public-policies-to-address-obesity-pediatric-obesity-2017-365?t=1500)
- "With pension plans, when employees must opt in (default is not enrolled), about 50% enroll; when employees are enrolled by default but can opt out, enrollment approaches 100%." — Kelly Brownell (epidemiological) [Ep 3 · 9:00](https://library.globalcastmd.com/watch/public-policies-to-address-obesity-pediatric-obesity-2017-365?t=540)
- "In countries using opt-out organ donation (default is donor status), consent rates reach 99.98%; in countries using opt-in systems like the US, rates are much lower." — Kelly Brownell (epidemiological) [Ep 3 · 10:00](https://library.globalcastmd.com/watch/public-policies-to-address-obesity-pediatric-obesity-2017-365?t=600)
- "A tax of about 1 penny per ounce increases beverage price by about 15% and is expected to reduce consumption of sugar-sweetened beverages by about 15%." — Kelly Brownell (epidemiological) [Ep 3 · 34:01](https://library.globalcastmd.com/watch/public-policies-to-address-obesity-pediatric-obesity-2017-365?t=2041)
- "Evaluations in Mexico and Berkeley show that sugar-sweetened beverage taxes are being passed along to consumers and affecting behavior; in Mexico, there has been an increase in water consumption." — Kelly Brownell (epidemiological) [Ep 3 · 34:01](https://library.globalcastmd.com/watch/public-policies-to-address-obesity-pediatric-obesity-2017-365?t=2041)
- "Tobacco taxes have an especially powerful effect on youth because youth tend to have less expendable resources than adults and are therefore particularly price sensitive." — Kelly Brownell (epidemiological) [Ep 3 · 34:01](https://library.globalcastmd.com/watch/public-policies-to-address-obesity-pediatric-obesity-2017-365?t=2041)
- "The US government spends $4 billion worth of SNAP benefits on soda every year." — Kelly Brownell (epidemiological) [Ep 3 · 39:51](https://library.globalcastmd.com/watch/public-policies-to-address-obesity-pediatric-obesity-2017-365?t=2391)
- "Heavy subsidies for commodity crops like corn and soybeans began in the Nixon administration, leading to low-cost ingredients that the food industry processed into snack foods, salty foods, beverages, and high fructose corn syrup." — Kelly Brownell (epidemiological) [Ep 3 · 35:11](https://library.globalcastmd.com/watch/public-policies-to-address-obesity-pediatric-obesity-2017-365?t=2111)
- "Research on changes in school nutrition standards has been very positive; kids not only eat healthier foods in school but also tend to eat somewhat healthier at home." — Kelly Brownell (epidemiological) [Ep 3 · 36:54](https://library.globalcastmd.com/watch/public-policies-to-address-obesity-pediatric-obesity-2017-365?t=2214)
- "Anecdotal cases of kids not liking healthier school foods and throwing them away tend to be temporary, especially with younger kids developing eating habits." — Kelly Brownell (clinical) [Ep 3 · 36:54](https://library.globalcastmd.com/watch/public-policies-to-address-obesity-pediatric-obesity-2017-365?t=2214)
- "Economists in Chicago found that soda taxes would probably lead to a little bit of job improvement rather than job loss because jobs would be created in other sectors." — Kelly Brownell (epidemiological) [Ep 3 · 43:51](https://library.globalcastmd.com/watch/public-policies-to-address-obesity-pediatric-obesity-2017-365?t=2631)
- "Philadelphia's sugar-sweetened beverage tax is 1.5 cents per ounce, which is 50% higher than the penny-per-ounce tax used in Berkeley." — Kelly Brownell (epidemiological) [Ep 3 · 34:01](https://library.globalcastmd.com/watch/public-policies-to-address-obesity-pediatric-obesity-2017-365?t=2041)
- "Using a tax calculator algorithm, the state of California would generate more than a billion dollars per year from a 1-cent-per-ounce sugar-sweetened beverage tax." — Kelly Brownell (epidemiological) [Ep 3 · 28:20](https://library.globalcastmd.com/watch/public-policies-to-address-obesity-pediatric-obesity-2017-365?t=1700)
- "Mayor Nutter of Philadelphia introduced a soda tax focused on health benefits and came very close to passage but did not succeed; Mayor Kenny later succeeded by framing it around funding early childhood education." — Kelly Brownell (epidemiological) [Ep 3 · 30:00](https://library.globalcastmd.com/watch/public-policies-to-address-obesity-pediatric-obesity-2017-365?t=1800)
- "In the 280 schools in Maine's 5210 program, when healthy foods are put in front of kids in a positive way, they eat them; adults and teachers have a harder time adjusting." — Tory (clinical) [Ep 3 · 38:28](https://library.globalcastmd.com/watch/public-policies-to-address-obesity-pediatric-obesity-2017-365?t=2308)
- "The obesity public health community and hunger advocacy community are at an impasse over restricting sugar-sweetened beverages in SNAP benefits, with both sides having dug in their heels." — Kelly Brownell (opinion) [Ep 3 · 39:51](https://library.globalcastmd.com/watch/public-policies-to-address-obesity-pediatric-obesity-2017-365?t=2391)
- "The hunger community believes that restricting SNAP benefits for sugar-sweetened beverages would further stigmatize people already facing poverty-related stigma." — Kelly Brownell (host_summary) [Ep 3 · 39:51](https://library.globalcastmd.com/watch/public-policies-to-address-obesity-pediatric-obesity-2017-365?t=2391)
- "New York City proposed a pilot study to test adjusted SNAP benefits excluding sugar-sweetened beverages, but USDA declined, saying New York was too big for a pilot study." — Kelly Brownell (epidemiological) [Ep 3 · 40:50](https://library.globalcastmd.com/watch/public-policies-to-address-obesity-pediatric-obesity-2017-365?t=2450)
- "The next revision of the food label is expected to include added sugar on the nutrition facts panel, similar to how trans fats were added before being banned." — Kelly Brownell (guideline) [Ep 3 · 36:40](https://library.globalcastmd.com/watch/public-policies-to-address-obesity-pediatric-obesity-2017-365?t=2200)
- "National legislation is expected to require calorie labeling on menus of all chain restaurants around the country." — Kelly Brownell (guideline) [Ep 3 · 36:40](https://library.globalcastmd.com/watch/public-policies-to-address-obesity-pediatric-obesity-2017-365?t=2200)
- "Of 12-year-olds with BMI at 99th percentile, all will grow up to have BMIs greater than 30, 88% will have BMIs greater than 35, and 2/3 will have class 3 obesity, according to the Bogalusa Heart Study." — Claudia Fox (epidemiological) [Ep 4 · 9:30](https://library.globalcastmd.com/watch/pharmacology-pediatric-obesity-2017-366?t=570)
- "Severe obesity is defined as BMI greater than 1.2 times the 95th percentile." — Claudia Fox (guideline) [Ep 4 · 13:00](https://library.globalcastmd.com/watch/pharmacology-pediatric-obesity-2017-366?t=780)
- "Only 2% of teenagers with severe obesity demonstrated clinically significant BMI reduction with lifestyle modification therapy." — Claudia Fox (clinical) [Ep 4 · 15:30](https://library.globalcastmd.com/watch/pharmacology-pediatric-obesity-2017-366?t=930)
- "In a study comparing inpatient (6 months) versus outpatient lifestyle modification therapy followed for 2 years, there was no statistically significant difference in outcomes at 2 years despite better response during inpatient treatment." — Claudia Fox (clinical) [Ep 4 · 17:00](https://library.globalcastmd.com/watch/pharmacology-pediatric-obesity-2017-366?t=1020)
- "Mutations in the melanocortin 4 receptor (MC4R) account for the most common single gene mutation causing early onset severe obesity in pediatrics." — Claudia Fox (clinical) [Ep 4 · 21:00](https://library.globalcastmd.com/watch/pharmacology-pediatric-obesity-2017-366?t=1260)
- "Bupropion-naltrexone combination works by bupropion stimulating POMC cells to secrete alpha-MSH (which stimulates MC4 receptors to decrease hunger), while naltrexone blocks the auto-inhibitory feedback from beta-endorphin, allowing relatively more alpha-MSH activity." — Claudia Fox (clinical) [Ep 4 · 22:00](https://library.globalcastmd.com/watch/pharmacology-pediatric-obesity-2017-366?t=1320)
- "When people lose weight, they experience increased hunger, decreased satiety, increased preference for highly palatable foods, and increased metabolic efficiency—all promoting weight regain." — Claudia Fox (clinical) [Ep 4 · 28:00](https://library.globalcastmd.com/watch/pharmacology-pediatric-obesity-2017-366?t=1680)
- "Bariatric surgery is currently the most effective and durable treatment for severe obesity in adolescents." — Claudia Fox (clinical) [Ep 4 · 29:00](https://library.globalcastmd.com/watch/pharmacology-pediatric-obesity-2017-366?t=1740)
- "Orlistat is a lipase inhibitor that blocks absorption of about 30% of fat, is FDA approved for children 12 and older, and in the largest RCT of about 500 patients showed placebo-subtracted BMI difference of about 0.8 units at one year." — Claudia Fox (clinical) [Ep 4 · 30:00](https://library.globalcastmd.com/watch/pharmacology-pediatric-obesity-2017-366?t=1800)
- "Phentermine is FDA approved for age 16 and older (from 1950s approval), but there have been no RCTs in adolescents longer than 1 month duration." — Claudia Fox (clinical) [Ep 4 · 31:00](https://library.globalcastmd.com/watch/pharmacology-pediatric-obesity-2017-366?t=1860)
- "Among adults, phentermine produces mean weight loss of about 3.5 kg." — Claudia Fox (clinical) [Ep 4 · 31:30](https://library.globalcastmd.com/watch/pharmacology-pediatric-obesity-2017-366?t=1890)
- "In studies of adults on phentermine, there have been no withdrawal symptoms upon abruptly stopping and no reports of increased blood pressure, probably because patients are losing weight." — Claudia Fox (clinical) [Ep 4 · 32:00](https://library.globalcastmd.com/watch/pharmacology-pediatric-obesity-2017-366?t=1920)
- "In a chart review of 25 patients on phentermine only for 6 months plus lifestyle modification, compared to 274 receiving only lifestyle modification, there was about a 4% decrease in BMI favoring the phentermine group." — Claudia Fox (clinical) [Ep 4 · 33:00](https://library.globalcastmd.com/watch/pharmacology-pediatric-obesity-2017-366?t=1980)
- "After many studies of metformin, we can expect about a one unit decrease in BMI." — Claudia Fox (clinical) [Ep 4 · 34:10](https://library.globalcastmd.com/watch/pharmacology-pediatric-obesity-2017-366?t=2050)
- "Liraglutide, a GLP-1 agonist, has recently been FDA approved for obesity in adults." — Claudia Fox (clinical) [Ep 4 · 34:40](https://library.globalcastmd.com/watch/pharmacology-pediatric-obesity-2017-366?t=2080)
- "In a pilot study of exenatide (GLP-1 agonist) with about 25 patients, during the first 3 months double-blinded portion, there was a placebo-subtracted effect of about 3% in BMI favoring the exenatide group." — Claudia Fox (clinical) [Ep 4 · 35:20](https://library.globalcastmd.com/watch/pharmacology-pediatric-obesity-2017-366?t=2120)
- "In a chart review of patients taking topiramate only (no other medications) with lifestyle modification therapy, there was about a 6% decrease in BMI at 6 months." — Claudia Fox (clinical) [Ep 4 · 36:30](https://library.globalcastmd.com/watch/pharmacology-pediatric-obesity-2017-366?t=2190)
- "In an RCT of topiramate 75mg/day after meal replacement induction phase, there was no statistically significant effect between topiramate and placebo groups by study end." — Claudia Fox (clinical) [Ep 4 · 37:10](https://library.globalcastmd.com/watch/pharmacology-pediatric-obesity-2017-366?t=2230)
- "Topiramate at 75mg/day was safe in adolescents, with extensive neurocognitive testing showing no signal of cognitive deficits." — Claudia Fox (clinical) [Ep 4 · 39:00](https://library.globalcastmd.com/watch/pharmacology-pediatric-obesity-2017-366?t=2340)
- "Topiramate is FDA approved down to age 2 for seizures and has been used in pediatrics for decades." — Claudia Fox (clinical) [Ep 4 · 38:50](https://library.globalcastmd.com/watch/pharmacology-pediatric-obesity-2017-366?t=2330)
- "Obesity is a chronic disease requiring indefinite medication treatment; stopping the medication results in weight regain, similar to stopping antihypertensive medication causing blood pressure to rise." — Claudia Fox (opinion) [Ep 4 · 40:50](https://library.globalcastmd.com/watch/pharmacology-pediatric-obesity-2017-366?t=2450)
- "Recently FDA-approved medications for adult obesity (age 18+) include topiramate-phentermine combination, liraglutide, naltrexone-bupropion combination, and lorcaserin, approved for BMI >30 or >27 with weight-related comorbidities." — Claudia Fox (clinical) [Ep 4 · 41:40](https://library.globalcastmd.com/watch/pharmacology-pediatric-obesity-2017-366?t=2500)
- "Early success in weight management predicts long-term weight loss success, according to adult literature." — Claudia Fox (clinical) [Ep 4 · 40:20](https://library.globalcastmd.com/watch/pharmacology-pediatric-obesity-2017-366?t=2420)
- "Bariatric surgery is seen as more acceptable than pharmacotherapy for pediatric obesity, despite being arguably riskier and irreversible." — Claudia Fox (opinion) [Ep 4 · 41:40](https://library.globalcastmd.com/watch/pharmacology-pediatric-obesity-2017-366?t=2500)
- "64% of the population owns smartphones" — Kristen Fuller (host_summary) [Ep 6 · 1:37](https://library.globalcastmd.com/watch/nutrition-journal-club-pediatric-obesity-2017-369?t=97)
- "Weight loss is one of the most popular categories for health-related mobile app downloads" — Kristen Fuller (host_summary) [Ep 6 · 1:45](https://library.globalcastmd.com/watch/nutrition-journal-club-pediatric-obesity-2017-369?t=105)
- "Evidence-based behavioral change techniques are proven to support weight loss" — Kristen Fuller (host_summary) [Ep 6 · 2:05](https://library.globalcastmd.com/watch/nutrition-journal-club-pediatric-obesity-2017-369?t=125)
- "There has not been research to see if evidence-based behavior change techniques are actually incorporated in the programming of diet tracking apps" — Kristen Fuller (host_summary) [Ep 6 · 2:25](https://library.globalcastmd.com/watch/nutrition-journal-club-pediatric-obesity-2017-369?t=145)
- "Portions are frequently underestimated with barcode scanning and food item searching methods of diet tracking" — Kristen Fuller (host_summary) [Ep 6 · 3:15](https://library.globalcastmd.com/watch/nutrition-journal-club-pediatric-obesity-2017-369?t=195)
- "Adherence and frequency of diet self-monitoring is significantly associated with weight loss and is of greater importance than the accuracy of the nutritional data tracked" — Kristen Fuller (host_summary) [Ep 6 · 3:35](https://library.globalcastmd.com/watch/nutrition-journal-club-pediatric-obesity-2017-369?t=215)
- "Just-in-time reporting using smartphones to take pictures of food has been studied and proven as a valid assessment of dietary intake in both adults and adolescents" — Kristen Fuller (host_summary) [Ep 6 · 4:40](https://library.globalcastmd.com/watch/nutrition-journal-club-pediatric-obesity-2017-369?t=280)
- "Diet self-monitoring is associated with weight loss with the addition of immediate provision of feedback" — Kristen Fuller (host_summary) [Ep 6 · 5:30](https://library.globalcastmd.com/watch/nutrition-journal-club-pediatric-obesity-2017-369?t=330)
- "The study reviewed 29 mobile apps that met inclusion criteria for diet tracking via photos" — Kristen Fuller (host_summary) [Ep 6 · 6:30](https://library.globalcastmd.com/watch/nutrition-journal-club-pediatric-obesity-2017-369?t=390)
- "Two apps (YouFood and Food Feedback) included 11 of the 13 behavior change techniques evaluated" — Kristen Fuller (host_summary) [Ep 6 · 8:00](https://library.globalcastmd.com/watch/nutrition-journal-club-pediatric-obesity-2017-369?t=480)
- "18 out of 29 apps (62%) did not provide any feedback at all on food photo posts" — Kristen Fuller (host_summary) [Ep 6 · 8:20](https://library.globalcastmd.com/watch/nutrition-journal-club-pediatric-obesity-2017-369?t=500)
- "Only 1 of the 29 apps used professionals exclusively to provide feedback" — Kristen Fuller (host_summary) [Ep 6 · 8:40](https://library.globalcastmd.com/watch/nutrition-journal-club-pediatric-obesity-2017-369?t=520)
- "3 apps offered an option of professional feedback" — Kristen Fuller (host_summary) [Ep 6 · 8:55](https://library.globalcastmd.com/watch/nutrition-journal-club-pediatric-obesity-2017-369?t=535)
- "7 of the 29 apps used only crowdsourcing or collective feedback" — Kristen Fuller (host_summary) [Ep 6 · 9:05](https://library.globalcastmd.com/watch/nutrition-journal-club-pediatric-obesity-2017-369?t=545)
- "6 apps did not use any self-regulation techniques at all" — Kristen Fuller (host_summary) [Ep 6 · 9:15](https://library.globalcastmd.com/watch/nutrition-journal-club-pediatric-obesity-2017-369?t=555)
- "Providing general encouragement, providing information about others' feedback, and feedback on user performance were the behavior change techniques found most often in the apps" — Kristen Fuller (host_summary) [Ep 6 · 9:40](https://library.globalcastmd.com/watch/nutrition-journal-club-pediatric-obesity-2017-369?t=580)
- "Specific goal setting, review of behavioral goals, modeling and demonstrating behavior, identifying barriers, and prompting follow-ups were rarely found in the apps despite being core components of effective clinical weight management programs" — Kristen Fuller (clinical) [Ep 6 · 10:10](https://library.globalcastmd.com/watch/nutrition-journal-club-pediatric-obesity-2017-369?t=610)
- "In the Strong for Life clinic, 24-hour recalls are used to identify the schedule of when the child eats and any structure around meals and snacks, which provides insight into parenting and household structure" — Kristen Fuller (clinical) [Ep 6 · 12:10](https://library.globalcastmd.com/watch/nutrition-journal-club-pediatric-obesity-2017-369?t=730)
- "Photo food logs are used to assess the quality of food, balance in food groups, and how people eat, with table settings providing additional behavioral information" — Kristen Fuller (clinical) [Ep 6 · 12:50](https://library.globalcastmd.com/watch/nutrition-journal-club-pediatric-obesity-2017-369?t=770)
- "Written food logs are used less frequently, primarily to discuss emotions and feelings with food" — Kristen Fuller (clinical) [Ep 6 · 13:20](https://library.globalcastmd.com/watch/nutrition-journal-club-pediatric-obesity-2017-369?t=800)
- "In-person professional feedback about food photos using motivational interviewing skills is the most crucial part of the photo food log process and what is missing from commercial apps" — Kristen Fuller (opinion) [Ep 6 · 14:20](https://library.globalcastmd.com/watch/nutrition-journal-club-pediatric-obesity-2017-369?t=860)
- "Families typically complete photo food logs about 3 times to see substantial improvement, working on small changes each round" — Kristen Fuller (clinical) [Ep 6 · 15:33](https://library.globalcastmd.com/watch/nutrition-journal-club-pediatric-obesity-2017-369?t=933)
- "When patients move very fast at meals and cannot remember to take pictures, it provides insight into eating behaviors and indicates bigger non-food-related issues to address before focusing on dietary changes" — Kristen Fuller (clinical) [Ep 6 · 16:18](https://library.globalcastmd.com/watch/nutrition-journal-club-pediatric-obesity-2017-369?t=978)
- "Photo food logs are typically set up for about 1 month, with families sending one picture per day on average, usually of the meal when the family is together at home" — Kristen Fuller (clinical) [Ep 6 · 17:12](https://library.globalcastmd.com/watch/nutrition-journal-club-pediatric-obesity-2017-369?t=1032)
- "The dietitian responds to acknowledge receipt of pictures and provide encouragement, but reserves detailed review and motivational interviewing for in-clinic visits because that interaction cannot be replicated over email" — Kristen Fuller (clinical) [Ep 6 · 17:50](https://library.globalcastmd.com/watch/nutrition-journal-club-pediatric-obesity-2017-369?t=1070)
- "Patients frequently use calorie counting apps like MyFitnessPal, often becoming very restrictive and unable to stick with them long-term" — Kristen Fuller (clinical) [Ep 6 · 25:52](https://library.globalcastmd.com/watch/nutrition-journal-club-pediatric-obesity-2017-369?t=1552)
- "The photo food log system requires a separate HIPAA-compliant email account where patients send pictures that are filed and organized by patient and by round number for review during clinic visits" — Kristen Fuller (clinical) [Ep 6 · 26:42](https://library.globalcastmd.com/watch/nutrition-journal-club-pediatric-obesity-2017-369?t=1602)
- "The goal of photo food logs is not to send a perfect picture but to send a picture and connect about food, with the most important element being maintaining rapport" — Kristen Fuller (clinical) [Ep 6 · 28:10](https://library.globalcastmd.com/watch/nutrition-journal-club-pediatric-obesity-2017-369?t=1690)
- "The photo food log approach tracks closely with the USDA MyPlate visual method, making it accessible for non-nutritionists to provide preliminary suggestions" — Wallace (clinical) [Ep 6 · 28:59](https://library.globalcastmd.com/watch/nutrition-journal-club-pediatric-obesity-2017-369?t=1739)
- "Photo food logs take more time in background preparation before seeing the patient but less time during the actual clinic visit compared to reviewing written food journals" — Kristen Fuller (clinical) [Ep 6 · 30:07](https://library.globalcastmd.com/watch/nutrition-journal-club-pediatric-obesity-2017-369?t=1807)
- "Risk factors for obesity are similar to characteristics that go into social and emotional development of children, including emotion regulation, temperament, inhibitory control, and reward sensitivity." — She'thel Reddy (host_summary) [Ep 5 · 2:52](https://library.globalcastmd.com/watch/psychology-journal-club-pediatric-obesity-2017-368?t=172)
- "General parenting interventions that improve parent-child communication in adolescence and social development in younger children have found a decrease in BMI, greater initiation of breastfeeding, and reduction in obesity." — She'thel Reddy (host_summary) [Ep 5 · 4:00](https://library.globalcastmd.com/watch/psychology-journal-club-pediatric-obesity-2017-368?t=240)
- "The study hypothesized that families at risk who declined intervention would demonstrate obesity-promoting feeding styles and their child would have an obese BMI by age 5." — She'thel Reddy (host_summary) [Ep 5 · 4:50](https://library.globalcastmd.com/watch/psychology-journal-club-pediatric-obesity-2017-368?t=290)
- "The study controlled for confounds including child gender, siblings, insurance status, birth weight, and maternal factors (age, race, country of origin, educational attainment, marital status, employment status, depressive symptoms, and BMI)." — She'thel Reddy (host_summary) [Ep 5 · 5:40](https://library.globalcastmd.com/watch/psychology-journal-club-pediatric-obesity-2017-368?t=340)
- "The Ages and Stages Questionnaire social-emotional subscale assessed self-regulation, compliance, communication, adaptive behaviors, autonomy, affect, and interpersonal interactions to define risk groups." — She'thel Reddy (host_summary) [Ep 5 · 6:20](https://library.globalcastmd.com/watch/psychology-journal-club-pediatric-obesity-2017-368?t=380)
- "The behavioral intervention had three levels: collaborative monitoring for least risk, on-site intervention (home or office visit) for greater risk, and outside referrals for long-term care for families with severe risks." — She'thel Reddy (host_summary) [Ep 5 · 7:00](https://library.globalcastmd.com/watch/psychology-journal-club-pediatric-obesity-2017-368?t=420)
- "Child feeding practices assessed included food consumption frequencies, eating out at restaurants, family meals, restriction, pressuring children to eat, setting limits, monitoring, reinforcing, using food as reward, using food for emotion regulation, parental role modeling, and maintaining healthy home food environment." — She'thel Reddy (host_summary) [Ep 5 · 7:50](https://library.globalcastmd.com/watch/psychology-journal-club-pediatric-obesity-2017-368?t=470)
- "The study used retrospective data from a community health center providing pediatric primary care, including mothers of 5-year-old children who had at least one social-emotional screening during the child's first 3 years of life." — She'thel Reddy (host_summary) [Ep 5 · 9:00](https://library.globalcastmd.com/watch/psychology-journal-club-pediatric-obesity-2017-368?t=540)
- "In the at-risk group that declined to participate, there was decreased limit setting, less restriction, more pressure to eat, lack of sensitivity or non-responsiveness to feeding cues, more permissive parenting, and mothers were more likely to report depressive symptoms." — She'thel Reddy (host_summary) [Ep 5 · 10:20](https://library.globalcastmd.com/watch/psychology-journal-club-pediatric-obesity-2017-368?t=620)
- "The study found a link between social-emotional problems during the first 3 years of life and a connection with obesity at age 5." — She'thel Reddy (host_summary) [Ep 5 · 12:40](https://library.globalcastmd.com/watch/psychology-journal-club-pediatric-obesity-2017-368?t=760)
- "Families that participated in the generalized intervention saw benefit in their child's weight status." — She'thel Reddy (host_summary) [Ep 5 · 13:10](https://library.globalcastmd.com/watch/psychology-journal-club-pediatric-obesity-2017-368?t=790)
- "The intervention can improve maternal-child relationships, suggesting the need to focus on more than just nutrition and activity, but the bigger family system including relationships and messages about eating and healthy habits." — She'thel Reddy (opinion) [Ep 5 · 13:30](https://library.globalcastmd.com/watch/psychology-journal-club-pediatric-obesity-2017-368?t=810)
- "Maternal depression can impact bonding with the child and the quality of interaction with the child." — She'thel Reddy (clinical) [Ep 5 · 15:00](https://library.globalcastmd.com/watch/psychology-journal-club-pediatric-obesity-2017-368?t=900)
- "In the Strong for Life Clinic, they screen for depression in children and also do a depression screener for the primary caregiver (usually the mother)." — She'thel Reddy (clinical) [Ep 5 · 15:20](https://library.globalcastmd.com/watch/psychology-journal-club-pediatric-obesity-2017-368?t=920)
- "A typical well-child checkup is 15 to 20 minutes, which is really pushing it, especially with an adolescent." (clinical) [Ep 5 · 16:27](https://library.globalcastmd.com/watch/psychology-journal-club-pediatric-obesity-2017-368?t=987)
- "A pilot project is adapting the 5210 message to the adult population and prenatal population, piloting in about 5 OB practices to look at how messages resonate and the role of OB providers in starting healthy eating and active living for the mother." (clinical) [Ep 5 · 17:56](https://library.globalcastmd.com/watch/psychology-journal-club-pediatric-obesity-2017-368?t=1076)
- "A quick assessment of parenting styles can be done by asking what a typical day is like, which reveals information about boundaries for bedtimes, rules for homework, and level of parental involvement." — She'thel Reddy (clinical) [Ep 5 · 20:40](https://library.globalcastmd.com/watch/psychology-journal-club-pediatric-obesity-2017-368?t=1240)
- "Practices that incorporate mental health within the practice find it valuable to have a psychologist with an open schedule who can see families during the same visit for issues like ADHD, school problems, or weight and feeding concerns." — She'thel Reddy (opinion) [Ep 5 · 21:30](https://library.globalcastmd.com/watch/psychology-journal-club-pediatric-obesity-2017-368?t=1290)
- "The intervention led to 15% incidence of obesity at 5 years old, a decrease but still an unacceptable number." (host_summary) [Ep 5 · 22:46](https://library.globalcastmd.com/watch/psychology-journal-club-pediatric-obesity-2017-368?t=1366)
- "Families at risk who participated had the lowest consumption of juice of any group, including those not at risk, suggesting messaging about sugary drinks stuck." — She'thel Reddy (host_summary) [Ep 5 · 23:10](https://library.globalcastmd.com/watch/psychology-journal-club-pediatric-obesity-2017-368?t=1390)
- "A study on well-baby group care in the first 2 years as an alternative model showed decreased prevalence in obesity at age 2 years in the group care." (host_summary) [Ep 5 · 24:34](https://library.globalcastmd.com/watch/psychology-journal-club-pediatric-obesity-2017-368?t=1474)
- "Group care models have shown increased satisfaction and improved rates of coming on time to clinic." (epidemiological) [Ep 5 · 25:04](https://library.globalcastmd.com/watch/psychology-journal-club-pediatric-obesity-2017-368?t=1504)
- "In group care, there is a central piece but then patients go to their own room for individual exams and time for sensitive or personal questions." (clinical) [Ep 5 · 26:20](https://library.globalcastmd.com/watch/psychology-journal-club-pediatric-obesity-2017-368?t=1580)
- "Group care requires patients to sign a HIPAA waiver, and parents have been amazingly open to share their stories with each other, perhaps even more open than they would have been with providers alone." (clinical) [Ep 5 · 26:50](https://library.globalcastmd.com/watch/psychology-journal-club-pediatric-obesity-2017-368?t=1610)
- "The study sample consisted of 13,006 children from 846 schools after excluding children with missing covariates and children from year-round schools" — Jody Dimanta (host_summary) [Ep 7 · 3:20](https://library.globalcastmd.com/watch/exercise-journal-club-pediatric-obesity-2017-370?t=200)
- "Children's height and weights were measured each fall and spring for a total of 6 occasions, with fall measurements taken 5-7 weeks after the first day of school and spring measurements taken 8 weeks before the last day of school" — Jody Dimanta (host_summary) [Ep 7 · 3:50](https://library.globalcastmd.com/watch/exercise-journal-club-pediatric-obesity-2017-370?t=230)
- "Obesity prevalence increased from 8.9% to 11.5% and overweight prevalence increased from 23.3% to 28.7% over the study period" — Jody Dimanta (host_summary) [Ep 7 · 5:10](https://library.globalcastmd.com/watch/exercise-journal-club-pediatric-obesity-2017-370?t=310)
- "All increases in obesity and overweight prevalences occurred during the two summer vacations with no increases during any of the three school years" — Jody Dimanta (host_summary) [Ep 7 · 5:40](https://library.globalcastmd.com/watch/exercise-journal-club-pediatric-obesity-2017-370?t=340)
- "During summer 1 and summer 2, both overweight and obesity prevalences increased by approximately 1% point per month" — Jody Dimanta (host_summary) [Ep 7 · 6:10](https://library.globalcastmd.com/watch/exercise-journal-club-pediatric-obesity-2017-370?t=370)
- "Over the average summer vacation of 2.6 to 2.7 months, there was a 2-3% rise in overweight and obesity points" — Jody Dimanta (host_summary) [Ep 7 · 6:40](https://library.globalcastmd.com/watch/exercise-journal-club-pediatric-obesity-2017-370?t=400)
- "During the school year, there was a decrease in obesity prevalence during kindergarten and second grade years" — Jody Dimanta (host_summary) [Ep 7 · 7:10](https://library.globalcastmd.com/watch/exercise-journal-club-pediatric-obesity-2017-370?t=430)
- "The standard deviation of BMI growth is approximately 3 times greater during the 2 summers than during the 3 school years" — Jody Dimanta (host_summary) [Ep 7 · 7:40](https://library.globalcastmd.com/watch/exercise-journal-club-pediatric-obesity-2017-370?t=460)
- "Children tend to sleep less and watch more screen time during summer" — Jody Dimanta (host_summary) [Ep 7 · 8:40](https://library.globalcastmd.com/watch/exercise-journal-club-pediatric-obesity-2017-370?t=520)
- "School-based interventions that tried to carry things over into the summer for families did not show any positive effect" — Jody Dimanta (host_summary) [Ep 7 · 9:20](https://library.globalcastmd.com/watch/exercise-journal-club-pediatric-obesity-2017-370?t=560)
- "In clinical practice, calculating total weekly structured activity minutes from PE class, recess, and extracurriculars reveals that some kids have as little as 100 minutes per week while others have as much as 500 minutes per week" — Jody Dimanta (clinical) [Ep 7 · 10:20](https://library.globalcastmd.com/watch/exercise-journal-club-pediatric-obesity-2017-370?t=620)
- "Activity planning is very individual and requires constantly evaluating what works for each family at a particular time" (opinion) [Ep 7 · 13:10](https://library.globalcastmd.com/watch/exercise-journal-club-pediatric-obesity-2017-370?t=790)
- "In the Choosing Healthy and Active Lifestyles for Kids program, schools can control kids during the school year and most kids eat breakfast and lunch at school, but there is not great control during summer" — John (clinical) [Ep 7 · 15:34](https://library.globalcastmd.com/watch/exercise-journal-club-pediatric-obesity-2017-370?t=934)
- "In Maine, physical activity is the behavior that isn't changing as much as desired over the last 10 years of tracking" — Tory (epidemiological) [Ep 7 · 16:44](https://library.globalcastmd.com/watch/exercise-journal-club-pediatric-obesity-2017-370?t=1004)
- "In Minnesota, the requirement for gym class is 1 year out of 4 years of high school, with only half of that year being gym and the other half being health" — Em Gootee (guideline) [Ep 7 · 18:00](https://library.globalcastmd.com/watch/exercise-journal-club-pediatric-obesity-2017-370?t=1080)
- "There is a significant correlation between obesity and ADHD, with decreased dopamine activity proposed as a common underlying pathway contributing to both conditions" (clinical) [Ep 7 · 22:31](https://library.globalcastmd.com/watch/exercise-journal-club-pediatric-obesity-2017-370?t=1351)
- "Stimulants act to increase dopamine activity, and taking a break from stimulant medication puts patients in a position where they are seeking more input, which might be from food or other environmental stimuli" (clinical) [Ep 7 · 22:31](https://library.globalcastmd.com/watch/exercise-journal-club-pediatric-obesity-2017-370?t=1351)
- "For weight management, the recommendation is to take stimulant medication every day with no breaks, including weekends and summer, because it helps with functioning in every realm of life" (opinion) [Ep 7 · 22:31](https://library.globalcastmd.com/watch/exercise-journal-club-pediatric-obesity-2017-370?t=1351)
- "Beta blockers and antihistamines are medications known to aggravate obesity" — Alan (clinical) [Ep 7 · 23:24](https://library.globalcastmd.com/watch/exercise-journal-club-pediatric-obesity-2017-370?t=1404)
- "Some children on ADHD medications struggle to maintain weight and may need medication breaks, particularly when side effects include blood pressure issues or personality changes" — John (clinical) [Ep 7 · 23:38](https://library.globalcastmd.com/watch/exercise-journal-club-pediatric-obesity-2017-370?t=1418)
- "For children with obesity whose main ADHD manifestation is impulsivity, which can affect eating habits, staying on medication regularly is more likely to be recommended" — John (opinion) [Ep 7 · 23:38](https://library.globalcastmd.com/watch/exercise-journal-club-pediatric-obesity-2017-370?t=1418)

## Changelog
- Sep 15: 9 items added automatically

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