Clinical Summary
Obesity in Children and Adolescents: Screening
June 20, 2017
Recommendations made by the USPSTF are independent of the U.S. government. They should not be construed as an official position of the Agency for Healthcare Research and Quality or the U.S. Department of Health and Human Services.
| Population | Children and adolescents 6 y and older |
|---|---|
| Recommendation | Screen for obesity; offer or refer children and adolescents with obesity to comprehensive, intensive behavioral interventions to promote improvements in weight status. Grade: B |
| Risk Assessment | All children and adolescents are at risk for obesity and should be screened; specific risk factors include parental obesity, poor nutrition, low levels of physical activity, inadequate sleep, sedentary behaviors, and low family income. |
| Screening Tests | BMI measurement, using height and weight, is the recommended screening test for obesity. Obesity is defined as an age- and sex-specific BMI in the 95th percentile or greater. |
| Interventions | Comprehensive, intensive behavioral interventions of ≥26 contact hours resulted in weight loss. Effective interventions consisted of multiple components, including: sessions targeting both the parent and child (separately, together, or both); offering individual sessions (both family and group); providing information about healthy eating, safe exercising, and reading food labels; encouraging the use of stimulus control (eg, limiting access to tempting foods and screen time), goal setting, self-monitoring, contingent rewards, and problem solving; and supervised physical activity sessions. Providers included primary care clinicians, exercise physiologists, physical therapists, dieticians, diet assistants, psychologists, and social workers, but the more intensive interventions usually involved referral outside the primary care office. Evidence regarding pharmacotherapy interventions was inadequate. |
| Balance of Benefits and Harms | The USPSTF concludes with moderate certainty that the net benefit of screening for obesity in children and adolescents 6 y and older and offering or referring them to comprehensive, intensive behavioral interventions to promote improvements in weight status is moderate. |
| Other Relevant USPSTF Recommendations | The USPSTF has made recommendations on screening for primary hypertension and lipid disorders in children and adolescents. These recommendations are available on the USPSTF Web site (https://www.uspreventiveservicestaskforce.org). |
For a summary of the evidence systematically reviewed in making this recommendation, the full recommendation statement, and supporting documents, please go to www.uspreventiveservicestaskforce.org.
Abbreviation: BMI=body mass index.