Overweight Children - Prevention and Treatment
The prevalence of overweight among children and adolescents has dramatically increased. There may be vulnerable periods for weight gain during childhood and adolescence that also offer opportunities for prevention of overweight. Overweight in children and adolescents can result in a variety of adverse health outcomes, including type 2 diabetes, obstructive sleep apnea, hypertension, dyslipidemia, and the metabolic syndrome. The best approach to this problem is prevention of abnormal weight gain.
Overweight in childhood and adolescence is an important public health issue because of its rapidly increasing prevalence and associated adverse medical and social consequences. Recent studies have estimated that 15 percent of children in the United States are at risk for overweight, and an additional 15 percent are overweight. Important predictors of overweight include age, sex, race/ethnicity, and parental weight status. Generally, school-based prevention programs are not successful in reducing the prevalence of obesity.
As the problem of overweight and obesity among children gets worse, many doctors are concerned that these kids will face diabetes and related problems in the future. Tests to assess the body’s ability to handle glucose and insulin are complicated and costly. Even when these tests are done, the results aren’t always consistent and reliable in children.A simpler and less expensive test to screen children at risk of future problems would be very useful for focusing prevention and treatment efforts.
The first goal in getting kids to a more healthy weight should actually not be weight loss. Instead, the usual recommendation is for kids to just stop gaining weight, and then, as they get taller, they can ‘grow into’ their weight. An even more realistic goal might be to just not gain weight so fast though. For example, a 12 year old boy should usually gain about 10 pounds a year during the early teen years. If he gains much more, say 15-20 pounds, then he will quickly become overweight.
Rigorous trials are needed to determine whether secondary prevention in primary care is useful in the fight against the childhood obesity epidemic. Secondary prevention could equally be delivered by other primary healthcare professionals, such as nurses, dietitians and exercise specialists, should they achieve accessibility and funding stability equal to that of GPs. Ideally, their relative effectiveness should also be studied.
The USPSTF found fair evidence that body mass index (BMI) is a reasonable measure for identifying children and adolescents who are overweight or are at risk for becoming overweight. There is fair evidence that overweight adolescents and children aged 8 years and older are at increased risk for becoming obese adults. The USPSTF found insufficient evidence for the effectiveness of behavioral counseling or other preventive interventions with overweight children and adolescents that can be conducted in primary care settings or to which primary care clinicians can make referrals.
