A new Children's Hospital study has found more than a three-fold increase in the number of times physicians provided obesity counseling to their young patients.

Dr. Goutham Rao, clinical director of the Weight Management and Wellness Center at Children's Hospital, reviewed 10 years of national survey data.

If primary care doctors don't take counseling seriously, there is little hope for dealing with rising rates of childhood obesity, Dr. Rao said.

"It's actually kind of encouraging that more children are receiving counseling right now," he said.

That's because childhood obesity is on the rise. About 16 percent of children from ages 6 to 19 are overweight.

Between 1988 and 1994, 11 percent of 6- to 11-year-olds and 10.5 percent of 12- to 19-year-olds were overweight.

Dr. Rao used data gathered annually from doctors' offices by the National Ambulatory Medical Care Survey. His findings were published last week in Ambulatory Pediatrics.

In 2002, 15.4 percent of doctor visits included obesity counseling. In 1995, the lowest year, only 4.3 percent did.

Any advice regarding weight management, nutrition or exercise was considered to be obesity counseling. Doctors did not have to be specific in the survey about the content of the discussion.

"We're not able to distinguish between a physician who says your child needs to exercise more and lose weight and somebody who's provided a half-hour of counseling about soft drinks," Dr. Rao noted.

Most national organizations, such as the U.S. Preventive Services Task Force, recommend obesity counseling for all children.

"It's not just to achieve a healthy weight, but to maintain a healthy weight as well," Dr. Rao said.

Parents don't usually take their children to the doctor because they are worried about obesity, and doctors are uncomfortable bringing up weight issues.

According to a recently published study led by Dr. Eliana Perrin, of the University of North Carolina, only about one in 10 pediatricians thought they did an effective job at treating their overweight patients.

Specialized pediatric obesity centers are uncommon. At Children's weight management center, patients may spend three to four hours with experts, including the doctor, nutritionists, exercise specialists and behavioral therapist.

"That's just not possible in the primary care setting," Dr. Rao said.

He noted that the North Carolina study indicated that physicians were willing to do more if they, too, got better guidance.

"They're looking for more practical counseling tools about what exactly they can tell each parent and each child," he said.

Dr. Rao is now trying to create those tools. "I'm trying to develop a system for handling childhood obesity in primary care practices," he said.