By Andrew M. Seaman
(Reuters Health) - Children and teens should be screened for obesity at doctors’ offices starting at age 6 and advised to attend intensive weight management programs if needed, according to a U.S.-government backed panel.
The recommendation, from the U.S. Preventive Services Task Force (USPSTF), reinforces the panel’s previous guidelines, according to its chairperson.
“Overall, (the) prevalence of obesity has leveled off, but we do see increasing rates in some populations,” said Dr. David Grossman, of the Kaiser Permanente Washington Research Institute in Seattle. “We have not solved this problem and we must continue to work on this.”
The obesity rate among U.S. children in general is stable at about 17 percent but is still increasing among African American girls and Hispanic boys, the USPSTF writes in JAMA.
Children are considered obese if their body mass index (BMI), which is a measure of weight in relation to height, falls at or above the 95th percentile on the U.S. Centers for Disease Control and Prevention’s growth charts - which would mean the child’s BMI is higher than 95 percent of other kids of the same age and sex, according to the agency.
Referring children and their families to comprehensive and intensive weight management programs, with 26 hours or more of contact with specialists over two to 12 months, resulted in weight loss, USPSTF researchers found. Those contacts could include group therapy or individual sessions, education and goal setting.
“The amount of time these interventions consumed matters,” said Grossman. “Intensive usually means a minimum of 26 hours is required to see any effect of the intervention.”
The USPSTF also looked at the use of medications like metformin and orlistat among obese children for weight loss, but evidence was scarce and the panel could not make any recommendations.
Despite the lack of evidence on use of medications for treating obesity in children, new research since the USPSTF’s last recommendation in 2005 has made the new version stronger, Grossman said.
Dr. Stephen Cook, of the University of Rochester Medical Center in New York, said doctors can screen children and teens for obesity but families may not have access to the needed treatments since insurers may not pay for those programs.
“It really is sort of a form of weight bias in the sense that the system is ignoring this,” said Cook, who was not involved with the new USPSTF recommendation but is the Obesity Society’s ambassador to the American Academy of Pediatrics.
Also, some insurers may only pay for treatment for a limited amount of time, whereas “obesity is a chronic disease,” he told Reuters Health.
“You can’t necessarily cure it.”
Grossman said weight management programs for youth are not as widely available as they are for adults.
“Our hope is that these types of programs could someday be offered over telephone or televideo and that could overcome the access issues,” he said.