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Value of Childhood Obesity Screening Unclear

Researchers See Little Evidence That Screening Prevents Obesity-Related Illnesses
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WebMD Health News

July 5, 2005 -- Twice as many kids in the U.S. are overweight today as two decades ago, but a panel of experts says it is not clear how doctors can help.

In a newly released report, the U.S. Preventive Services Task Force concludes that there is little proof that the current practice of screening children in the doctor's office for overweight and obesity prevents obesity-related illness.

"The evidence is insufficient to recommend for or against routine screening … in children and adolescents as a means to prevent adverse health outcomes," the panel noted.

The task force also concluded that behavioral counseling and other interventions delivered by doctors during routine office visits may not do much good either.

"There are several gaps in the research evidence on screening and interventions for overweight children and adolescents in the primary care setting," they wrote.

Value of BMI Mixed

The panel based its report on a review of studies evaluating the impact of obesity screening and early treatment of overweight in kids and teens in the clinical setting.

The studies indicate that body mass index (BMI) -- an indirect measure of body fat which uses a person's weight -- may not be a useful measure in younger children.

In children, BMI is age and sex specific; when a child's BMI measure is greater than 95% of his peers, the child is categorized as overweight or obese. Children that are overweight and obese have a higher risk of being overweight and obese adolescents.

Health-related illness associated with childhood and adolescent obesity has the potential to persist into adulthood.

But Evelyn Whitlock, MD, MPH, who led the review team, says the value of measuring overweight in young children as a predictor of obesity in adulthood is unknown.

"The issue is what do you do with a 3-year-old in the 95th percentile, and what do you tell his parents," she tells WebMD. "We don't have the answers."

She adds that programs addressing overweight in older children and teens are not widely available, and that there is little evidence that intervention efforts aimed at this age group are effective.

The review is published in the July issue of the American Academy of Pediatricians' journal Pediatrics.

Parents Often Don't See Problem

In a related study also published in the journal, researchers reported that parents frequently don't recognize that their child is overweight, or say they feel powerless to do anything about it.

The researchers surveyed 151 parents of children; 62% of the kids were overweight or obese. The researchers found almost half of the parents (44%) did not see their child's weight as a problem and were classified as having no interest in changing behaviors in the next six months. Another 17% of parents did recognize that their child had a problem, and were thinking about making a change, but not soon.

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