Obesity screening at age 6

There is cancer screening. There is screening for diabetes. Now health experts urge for obesity screening in children starting at age 6 years. This is according to recommendations from an expert panel of the US Preventive Services Task Force (USPSTF) and published in the journal Pediatrics.

According to the panel led by chair Dr. Ned Calonge from the Colorado Department of Public Health and Environment in Denver.

“Since the 1970s, childhood and adolescent obesity has increased three- to sixfold. Approximately 12% to 18% of 2- to 19-year-old children and adolescents are obese (defined as having an age- and gender-specific BMI [body mass index] at >95th percentile)….Previously, the USPSTF found adequate evidence that BMI was an acceptable measure for identifying children and adolescents with excess weight.”

So what does this obesity screening in children entails? The USPSTF panel gives the following recommendations to primary health clinicians:

Routine measurements of weight and height during the so-called regular health maintenance visits in children aged 6 to 18 years old. With data on height and weight, body mass index (BMI) can be calculated. BMI is an indicator of excess weight or obesity.

Moderate-to-high interventions for those who need them. The USPSTF panel reviewed the current state of evidence and concluded that comprehensive, moderate- to high-intensity (but not low intensity) interventions can improve BMI in children with excess weight. Moderate- to high-intensity intervention programs as those which involve more than 25 hours of contact with the child and/or family during a 6-month period and include 3 components:

• healthy diet and/or weight loss
• counseling regarding physical activity recommendations or a physical activity program
• behavioral management techniques including setting goals and self monitoring.

The task force does not recommend the use of pharmacologic agents to manage obesity. Currently, there are anti-obesity drugs in the market that are used in combination with behavioral interventions but these drugs come with side effects that include increased heart rate and blood pressure and gastrointestinal problems.

The American Academy of Pediatrics (AAP) agrees with the latest USPSTF recommendations although the it would prefer to start screening even earlier – at age 2 years. According to AAP spokesperson Dr. Sandra Hassink:

“Recognition that screening is the first step to individual evaluation and counseling for obesity prevention and treatment should be standard in practice now. Working with families to screen for high-risk nutrition and activity behaviors that contribute to obesity in early childhood must be part of that task. With that said, the current USPSTF report is significant because it provides evidence that obesity treatment can be effective and extend beyond the immediate intervention and that pediatricians in the context of a medical home model that supports multidisciplinary care, with the appropriate supports of training and reimbursement, can provide effective obesity prevention and treatment for the families and children in their care.”

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