Response: First, do some good

McLaren and colleagues raised at least five notable questions in their critique of the Seven Steps Model. The present response to these questions indicates that: Obesity is a disease. Compared to the Spear and associates expert panel recommendations, the Seven Steps Model relies much less on an educational approach and provides more explicit direction to parents and healthcare providers about scientifically grounded treatments. It may present a problem for teenagers of normal weight to focus excessively on weight loss, but for overweight young people such focusing appears to help them lose weight and improve their eating and activity patterns. The interventions suggested in the Seven Steps model were also advocated in the Spear and associates expert panel recommendations (CBT, immersion, bariatric surgery). The extant scientific evidence supports the efficacy of these approaches for many overweight children. However, as indicated in the Seven Steps Model, many children and their families will require more intensive interventions (going up through the seven steps) in order to achieve substantial improvements in health and emotional well-being.