Healthcare providers should refer children 6 or older who are obese to comprehensive, intensive behavioral interventions, according to a recommendation released by the U.S. Preventive Services Task Force (USPSTF) on Tuesday, June 18.
Obesity in children and adolescents is defined as having a body mass index (BMI) that is higher than the BMI of 95% of children or adolescents of the same age and gender.
The finalized recommendation comes after a draft version was posted for public comment on the USPSTF website from Dec. 12, 2023, to Jan. 16, 2024. We blogged about the draft recommendation in December 2023.
In response to comments, the USPSTF clarified the types of studies it reviewed in arriving at its recommendation. The task force reviewed evidence on behavioral counseling and pharmacotherapy for weight loss or weight management that can be provided in or referred from a primary care setting. Interventions that did not include a weight-loss or weight-management component were deemed ineligible for review. Because surgical weight-loss interventions are generally not first-line preventive interventions, the USPSTF considered these interventions to be outside the scope of review.
The USPSTF’s finalized recommendation incorporates language regarding the harms associated with having a high BMI and the use of BMI for assessment and screening. It also identifies additional resources to help address obesity, including:
- The Community Guide by the U.S. Department of Health and Human Services’ (HHS) Community Preventive Services Task Force
- The Physical Activity Guidelines for Americans by HHS’ Office of Disease Prevention and Health Promotion
- The Centers for Disease Control and Prevention’s website
In the finalized recommendation, the USPSTF states that behavioral interventions include multiple components. Those components include offering counseling sessions that target both the parent and child; offering group sessions in addition to individual or single-family sessions; offering information about healthy eating, safe exercise, and reading food labels; and implementing techniques that encourage changes in behavior, such as diet and activity monitoring and goal setting.
The USPSTF also reviewed evidence on the use of weight-loss medications in children and adolescents. In the rationale for the updated recommendation, the task force states that it found inadequate evidence on the benefits of weight-loss medications, but it did find adequate evidence regarding harms from medication interventions based on the number of studies reporting gastrointestinal symptoms. The USPSTF noted that more research is needed on the long-term health outcomes and benefits of both behavioral and pharmacotherapy interventions.
In Arkansas, childhood obesity rates have continued to climb, according to annual data collected and analyzed by ACHI. Analyses of BMI data for the 2022-23 school year indicate that approximately 24% of Arkansas children attending public schools were classified as obese and 17% were classified as overweight, while 57% of children were classified as having a healthy weight and 2% were classified as underweight.
Other research by ACHI revealed concerning BMI growth patterns among certain children who were tracked over time, finding that among children who began kindergarten with obesity, BMIs increase at a higher rate through the eighth grade compared to their peers. Visit ACHI’s BMI Dashboard for additional information regarding the statewide analysis of BMI data collected in Arkansas’s public schools.
