USPSTF Issues Draft Recommendation on Obesity Screening

With 1 in 3 children and adolescents currently overweight or obese, the US Preventive Services Task Force (USPSTF) this month has issued a draft recommendation that children and teens be screened for obesity.

The USPSTF, which is taking comments on the policy through November 28, 2016, gave the recommendation a “B” grade, meaning insurers would be required to cover screenings under the Affordable Care Act (ACA)—although that law is likely to be rescinded by President-Elect Donald J. Trump and the Republican Congress.

The recommendation would apply to children age 6 or older. It calls for clinicians to screen them for obesity, which is defined by the CDC as having a body mass index (BMI) of 30 kg/m² or higher; and if they are diagnosed with obesity, “to refer them to comprehensive, intensive behavioral interventions to promote improvements in weight status.”

According to the draft document, approximately 17% of children and teens aged between 2 and 19 in the United States are obese, and almost 32% are overweight. While childhood obesity has stabilized after steadily rising for 3 decades—through initiatives that include a revamp of the National School Lunch Program and efforts to remove sugary drinks from elementary schools—it remains on the rise in certain populations, including African American girls and Hispanic boys.

Besides being at risk for future health problems, such diabetes and cardiovascular disease, children and teens who are obese are more likely to be bullied, which puts them at risk of isolation and inactivity. Obese children and teens are also at risk for sleep apnea and orthopedic problems, which can lead to disability in adulthood.

"Parents do not always recognize when their children are overweight," said USPSTF member Alex Kemper, MD, MPH, MS, in a press release. "Looking at BMI, or body mass index, as part of usual healthcare provides an opportunity to identify children who have obesity and refer them to a comprehensive program, leading to improved health outcomes."

This draft recommendation is largely consistent with the USPSTF's 2010 final recommendation, but adds the term "adolescents" to further clarify the population to which the recommendation applies.

The USPSTF examined the evidence on screening for obesity in children and adolescents and the benefits and harms of weight management interventions. Conditions when bariatric surgery was appropriate were considered out of the scope of this review, but it has received increased attention this year. In May, the American Association of Clinical Endocrinologists issued guidelines for the treatment of obesity, including when bariatric surgery might be appropriate in teens.