The US Preventive Services Task Force (Task Force) has posted a final recommendation statement on interventions for high body mass index (BMI) in children and adolescents. The Task Force recommends clinicians provide or refer children and teens with a high BMI to intensive, comprehensive behavioural interventions.
The Grade B recommendation applies to children and adolescents aged 6 years and older with a high BMI. Nearly 20% of children and teens in the United States have a high BMI, which is sometimes referred to as having obesity. BMI is calculated from a child’s height and weight and is plotted on a growth chart. Obesity is defined as a BMI at or above the 95th percentile for age and sex on the growth chart.
“Almost one out of every five children and teens in the US has a high BMI,” said Task Force member, Dr John M Ruiz, professor of clinical psychology in the Department of Psychology at the University of Arizona (UA) and the Associate Director of equity, diversity, inclusivity, and accessibility at the UA Cancer Center. “Fortunately, there are a variety of effective intensive behavioural interventions available that can help kids with a high BMI achieve a healthy weight, while improving quality of life.”
Comprehensive, intensive behavioural interventions may include education about healthy eating habits, counselling on behavioural change techniques, such as goal setting and problem-solving, and supervised exercise sessions. Effective interventions include at least 26 or more hours with a healthcare professional over one year, which requires commitment from children and their families. This recommendation is for children and adolescents with a high BMI, but the Task Force encourages all kids and their families to follow healthy habits.
“We know that there are proven strategies to help kids who have a high BMI achieve a healthy weight,” added Task Force chair, Dr Wanda Nicholson, a senior associate dean for diversity, equity, and inclusion and professor of prevention and community health at the Milken Institute School of Public Health at the George Washington University. “These interventions work best when both kids and parents are engaged, so it is important that healthcare professionals provide support in identifying which counselling interventions are available, accessible, and a good fit for the family.”
The Task Force also reviewed evidence on weight loss medications but found that more research is needed to fully understand the long-term health outcomes of medications, including the possible harms of long-term medication use. Other important areas of research gaps identified by the Task Force include how a change in BMI impacts overall, long-term health; the long-term health outcomes and benefits of interventions; and how clinicians can best talk to children, adolescents, and their families about weight loss.
These gaps are particularly important to address in populations with the highest rates of high BMI, which include Hispanic/Latino, Native American/Alaska Native, and Black children and adolescents, and children from lower-income families.
The Task Force’s final recommendation statement and corresponding evidence summary have been published online, ‘Interventions for High Body Mass Index in Children and Adolescents - US Preventive Services Task Force Recommendation Statement’, in the Journal of the American Medical Association. To access this paper, please click here