Childhood obesity is prevalent, pervasive, resistant and destructive. Strategies to deal with the pandemic of childhood obesity can include “upstream” primary prevention approaches, secondary prevention interventions targeted at overweight children or those with other predisposing risk characteristics, or “downstream” tertiary treatments for morbidly obese children. Successful intervention strategies at the population level have been elusive, with most interventions achieving minimal success, leading to recommendations of a social-ecological (multilevel) approach.1 In many countries it is recommended that primary care physicians provide surveillance and counsel ling services for overweight and obese children and youth.1 ,2 The article by Wake and colleagues describes a randomised controlled trial examining the outcomes and costs associated with primary care surveillance and weight management intervention for overweight and obese children, adding experimental evidence to this understudied area.

This component of the LEAP …