Kids should be screened for obesity, according to American task force

An influential advisory panel says school-aged youngsters and teens should be screened for obesity and sent to intensive behaviour treatment if they need to lose weight — a move that could transform how doctors deal with overweight children.

In the United States

In the United States

CHICAGO — An influential advisory panel says school-aged youngsters and teens should be screened for obesity and sent to intensive behaviour treatment if they need to lose weight — a move that could transform how doctors deal with overweight children.

Treating obese kids can help them lose weight, the panel of doctors said in issuing new guidelines Monday. But that’s only if it involves rigorous diet, activity and behaviour counselling.

Just five years ago, the same panel — the U.S. Preventive Services Task Force — found few benefits from pediatric obesity programs. Since then, the task force said, studies have shown success.

But that has only come with treatment that is costly, hard to find and hard to follow.

The good news is, “you don’t have to throw your arms up and say you can’t do anything,” said task force chairman Dr. Ned Calonge. “This is a recommendation that says there are things that work.”

Calonge said the panel recognizes that most pediatricians are not equipped to offer the necessary kind of treatment, and that it may be hard to find, or afford, places that do. The recommendations merely highlight scientific evidence showing what type of programs work — “not whether or not those services are currently available,” he said.

The new advice, published online in the journal Pediatrics, could serve as a template for creating obesity programs. It also might remove one important cost barrier: Calonge said insurers will no longer be able to argue that they won’t provide coverage because treatment programs don’t work.

Evidence the panel evaluated shows intensive treatment can help children lose several pounds — enough for obese kids to drop into the “overweight” category, making them less prone to diabetes and other health problems. The treatment requires appointments at least once or twice a week for six months or more.

The recommendations follow government reports last week that showed obesity rates in kids and adults have held steady for about five years. Almost one-third of kids are at least overweight; about 17 per cent are obese.

The task force is the same group of government-appointed but independent experts whose new mammogram advice startled many women in November. That guidance — that most women don’t need routine mammograms until age 50 — is at odds with the American Cancer Society and several doctor groups.

In this case, the task force advice mirrors that of the American Academy of Pediatrics. Many pediatricians already measure their young patients’ height, weight and body mass index at yearly checkups.

Task force recommendations in 2005 said there wasn’t enough evidence to encourage routine obesity screening and treatment. The update is based on a review of 20 studies, most published since 2005, involving more than 1,000 children.

The review excluded studies on obesity surgery, which is only done in extreme cases.

The panel stopped short of recommending two diet drugs approved for use in older children, Xenical and Meridia, because of potential side effects including elevated heart rate, and no evidence that they result in lasting weight loss.

Calonge, chief medical officer for Colorado’s public health department, said evidence is lacking on effective treatment for very young children, so the recommendations apply to ages 6 to 18.

The most effective treatment often involves counselling parents along with kids, group therapy and other programs that some insurers won’t cover. But adequate reimbursement “would be critical” to implementing these programs, Dr. Sandra Hassink, a member of the American Academy of Pediatrics’ board of directors, said in a Pediatrics editorial.

Dr. Helen Binns, who runs a nutrition clinic at Chicago’s Children’s Memorial Hospital, says such programs are scarce partly because they’re so costly. Her own hospital — a large institution in one of Chicago’s wealthiest neighbourhoods — doesn’t have one.

Many families with obese or overweight children can’t afford that type of treatment. And it’s not just cost. Many aren’t willing to make the necessary lifestyle changes, she said.

“It requires a big commitment factor on the part of the parent, because they need to want to change themselves, and change family behaviour,” Binns said.

Get local stories you won't find anywhere else right to your inbox.
Sign up here

Just Posted

A vial of some of the first 500,000 of the two million AstraZeneca COVID-19 vaccine doses that Canada has secured through a deal with the Serum Institute of India in partnership with Verity Pharma at a facility in Milton, Ont., on Wednesday, March 3, 2021. THE CANADIAN PRESS/Carlos Osorio - POOL
Canada negotiating contracts to secure COVID-19 booster shots for next year: Anand

Vaccine suppliers already testing new versions against variants

Red Deer Catholic Regional Schools has a new public engagement website. (Contributed graphic)
Red Deer Catholic Schools are launching a new public engagement website

RDCRS Connects will provide feedback opportunities

Alberta is on pace to administer more than 300,000 COVID-19 vaccine doses per week, according to the provincial government. THE CANADIAN PRESS/Andrew Vaughan
One million COVID-19 vaccine doses administered in Alberta

Alberta hit a milestone in the fight against COVID-19 this week. As… Continue reading

(Government of Canada)
Liberal MP caught stark naked during House of Commons video conference

William Amos, in Quebec, appeared on the screens of his fellow members of Parliament completely naked

opinion
Opinion: Waiting 4 months between vaccine doses too long

“It’s not just a matter of potency, it’s a matter of the… Continue reading

Richie Laryea of Toronto FC, left, and Jean Meneses of Mexico's Leon battle for the ball during a CONCACAF Champions League soccer match in Leon, Mexico, in Leon, Wednesday, April 7, 2021. Toronto FC hosts Club Leon in the second leg of their Scotiabank CONCACAF Champions League round-of-16 tie holding a valuable away goal after a 1-1 draw last week in Mexico. THE CANADIAN PRESS/AP/Mario Armas
Injury-riddled Toronto FC dispatches Club Leon in CONCACAF Champions League play

Injury-riddled Toronto FC dispatches Club Leon in CONCACAF Champions League play

Winnipeg Jets' Dylan DeMelo (2) skates the puck around Ottawa Senators' Thomas Chabot (72) as he holds off Winnipeg Jets' Mason Appleton (22) during first-period NHL action in Ottawa on Wednesday, April 14, 2021. THE CANADIAN PRESS/Sean Kilpatrick
Winnipeg Jets score two third-period goals to secure 3-2 victory over Ottawa Senators

Winnipeg Jets score two third-period goals to secure 3-2 victory over Ottawa Senators

Toronto Raptors forward Chris Boucher (25) shoots over San Antonio Spurs forward Keldon Johnson (3) during the first half of an NBA basketball game Wednesday, April 14, 2021, in Tampa, Fla. (AP Photo/Chris O'Meara)
Anunoby, Siakam rally Raptors past Spurs 117-112

Anunoby, Siakam rally Raptors past Spurs 117-112

John Furlong pitches a broader B.C. bid for 2030 Winter Games

John Furlong pitches a broader B.C. bid for 2030 Winter Games

New York Yankees starting pitcher Corey Kluber throws against the Toronto Blue Jays during the first inning of a baseball game Wednesday, April 14, 2021, in Dunedin, Fla. (AP Photo/Mike Carlson)
Bichette hits 2nd homer in 9th, Blue Jays beat Yankees 5-4

Bichette hits 2nd homer in 9th, Blue Jays beat Yankees 5-4

Oklahoma City Thunder forward Luguentz Dort (5) goes to the basket as Utah Jazz forward Jarrell Brantley (5) defends during the second half of an NBA basketball game Tuesday, April 13, 2021, in Salt Lake City. THE CANADIAN PRESS/AP, Rick Bowmer
Undrafted Montreal native Dort continues to smash “glass ceilings” in NBA

Undrafted Montreal native Dort continues to smash “glass ceilings” in NBA

A man wearing a protective mask to help curb the spread of the coronavirus walks past banners for the Tokyo 2020 Olympic and Paralympic Games in Tokyo, Wednesday, April 14, 2021, to mark 100 days before the start of the Summer Games. THE CANADIAN PRESS/AP, Eugene Hoshiko
Rings on the Horizon: Tokyo Summer Olympics hit 100 days out marker

Rings on the Horizon: Tokyo Summer Olympics hit 100 days out marker

Most Read