Countering Obesity in Childhood and Adolescence

US Preventive Services Task Force Recommendation Statement

The US is the most obese nation in the world. Obesity is not just about increased heart disease or diabetes risk. It increases the risk of almost every known disease, including cancers and even infections. High obesity rates are the reason why average life expectancy is not increasing in the US, and it is rather below many developed nations that are spending much less on healthcare per capita relative to the US.

This means that overcoming obesity must be a priority for the nation. However, it is also vital to begin early enough. Childhood obesity is also on the rise in the US. About 20% of children aged 2 to 19 years in the US are obese or above the 95th percentile for age and sex.

Moreover, the number of overweight children increases with age. Thus, a significant number of young adults are obese in the US. Hence, it is little surprise that many diseases that used to be common in older adults are becoming common in young adults.

Hence, the US Preventive Services Task Force has come up with a recommendation statement to overcome the issue of overweight and obesity in children and adolescents.

The US Preventive Services Task Force (USPSTF) recommends that children and adolescents aged 6 years or older with a high BMI receive intensive behavioral interventions. These interventions should include at least 26 contact hours to achieve significant health benefits. The recommendation is based on a comprehensive review of evidence, focusing on such interventions' benefits and potential harms.

Pathway to Benefit

To gain the most from these interventions, it is essential that children and adolescents with high BMI participate in intensive behavioral programs. These programs should involve at least 26 contact hours, including activities like supervised physical exercise, nutritional education, and behavior change techniques. The goal is to support healthy weight loss and improve overall health outcomes.

The USPSTF aims to improve national health by evaluating preventive care services. They base their recommendations on evidence regarding the benefits and harms of services without considering the cost. 

Clinical decisions should consider the individual patient's needs, and the USPSTF emphasizes addressing health inequities caused by systemic issues like racism and gender-based discrimination.

The USPSTF finds that intensive behavioral interventions provide a moderate net benefit for children and adolescents with high BMI. Therefore, healthcare providers should offer or refer these patients to such programs to improve their health outcomes.

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Practice Considerations

USPSTF recommends that interventions include multiple components such as dietary education, physical activity, and behavior modification techniques. These programs often involve a multidisciplinary team and can be delivered in various settings, such as schools or healthcare facilities.

Although some medications can aid in weight loss, they are not the primary recommended intervention due to potential side effects and the need for long-term use to maintain benefits. Behavioral interventions remain the preferred method for managing high BMI in children and adolescents.

Similarly, other health organizations, such as the American Academy of Pediatrics and the Canadian Task Force on Preventive Health, support these strategies for managing high BMI in children and adolescents. They emphasize routine BMI monitoring, behavioral interventions, and multidisciplinary approaches to treatment.

Source:

US Preventive Services Task Force. (2024). Interventions for High Body Mass Index in Children and Adolescents: US Preventive Services Task Force Recommendation Statement. JAMA. https://doi.org/10.1001/jama.2024.11146