To the Editor.

I agree with Quattrin et al1 that referral of obese children to pediatric endocrinologists often occurs too late to promote restoration of weight to normal. As a pediatric endocrinologist practicing for 25 years in Los Angeles, California, I believe that late referral of overweight children by primary care physicians results from lack of routine charting of weight and/or BMI as standard care. However, several other factors also come into play.

However, my experience is that significant progress can be made even when referral occurs later than desirable.

In 1986, alarmed by increasing referrals of obese and overweight children, I began a program at Cedars-Sinai Medical Center, KidShape, for children aged 6 to 14 years. KidShape is an 8-week, 2-hour-long program, designed to provide a family-based group environment in which registered dietitians, licensed family therapists, and exercise physiologists help families develop more healthful dietary and exercise habits....

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