Screening and interventions for childhood overweight

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 no...

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Bibliographic Details
Main Authors: Whitlock, Evelyn P., Williams, Selvi (Author), Gold, Rachel Benson (Author), Smith, Paula (Author)
Corporate Authors: United States Agency for Healthcare Research and Quality, Oregon Health & Science University Evidence-based Practice Center
Format: eBook
Language:English
Published: Rockville (MD) Agency for Healthcare Research and Quality (US) 2005, July 2005
Series:Evidence syntheses
Subjects:
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Collection: National Center for Biotechnology Information - Collection details see MPG.ReNa
Description
Summary: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.
BACKGROUND: Childhood and adolescent overweight and obesity are related to health risks, medical conditions, and an increased risk of adult obesity, with attendant impacts on morbidity and mortality. The prevalence of overweight has increased over the last 25 years among all American children and adolescents, but particularly among racial/ethnic minorities. The relatively greater increase in the upper body mass index (BMI) percentiles compared with the lower suggests that severity of overweight is increasing. Although obesity is the presumed condition impacting health, the use of the terms "at risk for overweight" and "overweight" are preferred when describing relative weight status based on age- and sex-specific BMI percentiles for children and adolescents, as these terms are more accurate and less pejorative. CONCLUSIONS: BMI measurement to detect overweight in older adolescents could identify those at increased risk of developing adult obesity, and its consequent morbidities.
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
Item Description:Title from HTML header. - Updated by Effectiveness of primary care interventions for weight management in children and adolescents / prepared for Agency for Healthcare Research and Quality, U.S. Department of Health and Human Services ; prepared by Oregon Evidence-based Practice Center, Center for Health Research, Kaiser Permanente ; EPC Team, Evelyn P. Whitlock ... [et al.]. 2010
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