Policy Update: Considering the USPSTF Recommendations on Obesity Screenings for Children

By Rachael Solomon

The U.S. Preventive Services Task Force (USPSTF) has issued a draft position statement for public comment on their recommendations for screening children and adolescents for overweight and obesity. Feedback from the public will be collected and taken into account before a final draft is released. The USPSTF is recommending that clinicians screen for obesity in children and adolescents age six years and older and offer or refer them to comprehensive, intensive behavioral interventions to promote improvements in weight status.¹

This is relevant in today’s society because around 17% of children and adolescents ages 2 - 19 in the United States are considered obese, which is defined as having a Body Mass Index (BMI) > 95th percentile based on age and gender. Also, 32% of children and adolescents are classified as overweight with a BMI in the 85th - 94th percentile specific for age and gender. After rising for three decades, the rate of child and adolescent obesity has started to stabilize over the last decade. However, the proportion of children among the severely obese is still increasing.¹

These statistics are concerning because children and adolescents who are obese are at a higher risk for other health conditions such as mental health issues, asthma, obstructive sleep apnea, orthopedic problems, high blood pressure, high cholesterol and insulin resistance. If these issues are not treated and left unresolved, they can lead to type 2 diabetes and cardiovascular disease in the future. The good news is that prevention can go a long way in preventing the onset of any of these conditions.¹

The USPSTF found the BMI percentile for age and gender was the best method to assess weight status because it is simple to use, reliable and a strong predictor of adult obesity. USPSTF’s research has confirmed the benefits of early detection with the use of screenings and behavioral interventions for children and adolescents ages six years and up. Improvements in weight status and related factors can be seen even after 6 - 12 months of treatment including 26 hours per week of behavioral interventions and even greater increases in improvement with 52 hours per week of comprehensive behavioral interventions. These treatments seemed to have a greater effect because they included both the child and parent. Education was provided on healthy eating, safe exercising, goal setting, reading labels and self-monitoring.¹

A common concern about weight screening in children is the risk for potential harm to the child. However, USPSTF found little to no evidence of this risk among the research conducted. Evidence on the harm of using the diabetes medication Metformin needs furthering testing.¹

In conclusion, based on the research conducted by USPSTF there is moderate evidence to suggest that the benefits of screening outweigh any potential risks. If you would like to provide feedback to the USPSTF, please visit the website under sources and write your comment.¹

Sources

1 Draft Recommendation Statement, Obesity in Children and Adolescents: Screening