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Thursday, 2 January 2014

Screening and Interventions for Childhood Overweight

In the study to to examine the evidence for the benefits and harms of screening and earlier treatment of overweight in children and adolescents in clinical settings, researchers found that BMI measurement to detect overweight in older adolescents could identify those at increased risk of developing adult obesity, and its consequent morbidities. Promising interventions to address overweight adolescents in clinical settings are beginning to be reported but are not yet proven to have clinically significant benefits; nor are they widely available. Screening for the purposes of overweight categorization in children under age 12 to 13 who are not clearly overweight may not provide reliable risk categorization for adult obesity. Theoretical harms may occur from overweight labeling or from induced individual and parental concern. Screening approaches are further compromised by the fact that there is little generalizable evidence for interventions that can be conducted in primary care or are widely available for primary care referral. Despite this, the fact that many trials report short- to medium-term modest improvements (approximately 10%–20% decrease in percent overweight or a few units' change in BMI) suggests that overweight improvements in children and adolescents are possible. Experts have identified pragmatic clinical recommendations for lifestyle changes that could be applied to all children and adolescents regardless of risk. While monitoring growth and development in children and adolescents through BMI documentation at visits is prudent, care should be taken not to unnecessarily label children and adolescents as overweight or at risk for overweight until more is known about BMI as a risk factor, and effective interventions are available(1).

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(1) "Screening and Interventions for Childhood Overweight [Internet]". by Whitlock EP, Williams SB, Gold R, Smith P, Shipman S.