New Obesity Recommendations Face Uphill Battle

Courtesy of Flickr user ktheory

There is now enough evidence to recommend screening for overweight and obesity in children aged 6 years and older and enough evidence backing the efficacy of behavioral interventions of at least moderate intensity, according to the U.S. Preventive Services Task Force. (See story.)

Will this recommendation pack a big enough punch to kick-start a movement toward more screening and greater acceptance and awareness of the efficacy of behavioral interventions? It looks like it will be an uphill battle, if a new survey of members of the American Academy of Pediatrics gives a true indication.

The survey of 677 primary care clinicians in active practice revealed that only 52% assess BMI percentile for children older than 2 years and only 23% said they believe that there are good treatment strategies for overweight. Less than half said they are able to make referrals to interventional programs.

It also was notable that clinicians who are familiar with American Academy of Pediatrics guidelines on obesity screening and treatment were more likely to use BMI percentiles in their care and more likely to feel prepared to counsel patients.

Dr. Ned Calonge, the chair of the USPSTF, recognized that many clinicians won’t be able to offer referrals to weight management centers, but he said with greater recognition of the value of screening and the efficacy of treatment, greater availability of referral services and insurance coverage will hopefully follow. That will be key because 69% of providers in the survey said that insurance does not cover weight management programs, and only 15% reported that they can bill for overweight counseling and treatment separate from well-child visits.

Jeff Evans (@jeffaevans on Twitter)

3 Comments

Filed under Endocrinology, Diabetes, and Metabolism, Family Medicine, Pediatrics, Primary care, Uncategorized

3 responses to “New Obesity Recommendations Face Uphill Battle

  1. When children become fat it is essentially because they are eating salty food. Children are especially vulnerable to salt because of their small size and small blood volume, and because their blood vessels are weaker than those of adults. Salt, and the water it attracts to it, can more easily distend weak blood vessels than fully mature ones. The resulting increase in blood volume and other fluid retention results in weight gain, as well as higher blood pressure and many other undesirable consequences. The smaller the child, the less salt they should have – and a baby, of course, should have no salt at all. – Babies can die if they are fed salty food.

    Because children have much smaller bodies than adults it would be best if they had no more than half as much salt as adults. Most children, however, have much more than this because they eat so many snacks and instant foods. Just one cheeseburger, for instance, contains almost double the recommended daily salt maximum for children. There are high amounts of salt in packet soups, instant noodles, ketchup and sauces, sausages, burgers and savoury snacks. Fat children will lose weight fast if they eat less salt. And even faster still if they eat plenty of fresh fruit and unsalted vegetables, because these are rich in potassium, which helps to displace sodium from the body. Overweight children should not be put on a diet; dieting is harmful and unnecessary and does not usually result in weight loss. Once children start dieting it is often the beginning of a lifetime of yo-yo dieting and increasing weight and ill-health.

    Unfortunately bread contains a lot of salt and most families eat quite a lot of bread because of using it for sandwiches in packed lunches, and for toast, etc. Because of its high salt content bread is not a healthy food for little children or for anyone who is overweight. Some bread manufacturers have lowered the salt content of certain loaves, but most bread still usually contains 0.5g or more of sodium per 100g. This is too much. – Always check on the packet; look for the lowest sodium content.

    Cheese is often recommended as being good for children because it contains calcium, but cheese is not really good for children because it has a high salt content. So don’t give them a lot of it. Children can get plenty of calcium by drinking milk and by eating yogurt (but avoid the sort of yogurt that has lots of chemical additives).

  2. Hallo,
    ich habe unter http://www.tixuma.de/?ref=6934 einen Dienst gefunden, der seinen Usern Provisionen für die Benutzung seiner Suchmaschine bezahlt. Vielleicht ist das ja was für Dich. Die Teilnahme ist kostenlos und Du kannst Dir nebenbei etwas dazuverdienen.
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    Beste Grüße,
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  3. Hey, found your site by accident doing a search on Ask but I’ll definitely be returning. As for your post… I agree with a lot of what you’re saying here but wouldn’t it be just as easy to let it go? I mean why mess with your quality of life if you don’t have to?

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