The following articles taken from our February - April issue are available on early view here. Firstly Taylor et al report research priorities in childhood obesity management identified through a Delphi survey of Australian and New Zealand obesity clinicians and researchers. Hsia and colleagues have examined the way in which screening of obese paediatric patients for co-morbidities has been undertaken at Texas Children's Hospital (US) - finding that, even within such a tertiary specialist setting, adequate screening was being undertaken in only half of the attendees. This is an important paper and highlights how much more education and training is needed in clinical obesity management - especially in children. 

A paper by Midthjell et al looks into trends in overweight and obesity over 22 years in Norwegian adults. It is often thought that Scandinavian countries have been relatively immune from the scourge of obesity that affects countries across the world.  It seems, however that Norway is showing no signs of a halt in the increase of obesity.  From three national surveys spanning 1984 to 2008 there has been a continuous shift in the distribution curve of BMI and waist circumference to the right, demonstrating that the increase in body weight was occurring in all weight groups; the increases are greatest in the young. The authors found increases in sedentariness and speculate that this may relate to the particularly marked increases in waist circumference. With more and more people being overweight or obesity, now is the time to properly develop evidence-based clinical management programs.

Randomized controlled trials in clinical obesity are difficult to undertake and often complicated by problems such as high non-compliance rates, many potential confounders, and particular ethical issues. It's important, therefore, that we collect data from all sources. Liu and colleagues report their findings from a large group of individuals attending a Canadian Multidisciplinary Weight Management Program. They identify several important predictors of success, including age, ethnicity and comorbidities such as Type 2 diabetes. Gjevestad and colleagues also report interesting findings from a comparison study of secondary and tertiary care. In this report, they show that intensive efforts often reap the biggest rewards - findings that others have also reported. The question, of course, is always how to fund and deliver these types of intensive interventions, and more long-term data are needed regarding outcomes from specific programs (with appropriate health economic evaluations) before we can decide upon sweeping reforms to clinical practice delivery.

Two papers address bariatric surgical issues - the first reporting the unusual complication of mesenteric vein thrombosis following laparoscopic sleeve gastrectomy, and the second assessing psychological barriers to bariatric surgery. We hope, as the journal expands, we will receive more papers like these which focus on the medical aspects of bariatric surgical programs.

This issue also includes a case report of a man who, with multidisciplinary care and a two-step bariatric intervention, lost 170kg - resolving many of the associated medical and psychological problems. It is interesting to see the identified determinants of his success and think about how we can develop research programs to assess their influence on mainstream clinical outcomes.

Clinical Obesity continues to grow in size and quality, we are excited by its development and look forward to receiving your papers.