Based on new evidence that children and adolescents can be effectively treated for obesity, the U.S. Preventive Services Task Force recommends that clinicians screen children ages 6 to 18 years for obesity and refer them to programs to improve their weight status. The recommendations are explained in the special article, “Screening for Obesity in Children and Adolescents: US Preventive Services Task Force Recommendation Statement,” in the February issue of Pediatrics (appearing online Jan. 18).
The task force reviewed 20 clinical trials of behavioral and pharmacologic interventions for obesity and found comprehensive, moderate- to high-intensity programs are effective at helping children improve their body mass index (BMI). Comprehensive programs included 3 components: 1. counseling for weight loss or healthy diet; 2. counseling for physical activity or a physical activity program; and, 3. behavioral management techniques such as goal setting and self monitoring. Moderate- to high-intensity programs involve greater than 25 hours of contact with the child and/or the family over a 6-month period. Height and weight, from which BMI is calculated, are routinely measured during health maintenance visits. Families who seek treatment for obesity should look for comprehensive programs that address weight control through healthy food choices, physical activity and behavioral skill-building. The systematic review to support these recommendations is also published in this issue, under the title “Effectiveness of Weight Management Interventions in Children: A Targeted Systematic Review for the USPSTF.”
In an accompanying commentary, “Evidence for Effective Obesity Treatment: Pediatricians on the Right Track!”, pediatrician and American Academy of Pediatrics (AAP) Board of Directors member Sandra Hassink, MD, FAAP, examines the recommendations and how they complement those of the AAP, which call for routine obesity screening of children starting at age 2. An additional article in this issue, “Adoption of Body Mass Index Guidelines for Screening and Counseling in Pediatric Practice,” describes the results of a survey of AAP members that examined how frequently pediatricians screen for obesity in practice.
