Despite recommendations calling for pediatricians to target children at risk for childhood obesity, researchers found that overweight teenagers were no more likely than normal-weight teenagers to be screened or receive counseling for nutrition, physical activity, or emotional distress.
"These results are discouraging amid a rise in pediatric obesity and new guidelines that recommend screening by BMI status," researcher Carolyn Bradner Jasik, MD, of the University of California, San Francisco, and colleagues write in Pediatrics.
National guidelines call for pediatricians to target childhood obesity prevention efforts according to body mass index (BMI, a measure of weight in relation to height) status. In children and teens, a BMI in the 85th to the 94th percentile is considered overweight, and equal to or higher than the 95th percentile is considered obese.
They also recommend incorporating screening for emotional distress along with obesity screening because of the high rates of depression and anxiety among obese youth.
Overweight Teenagers Miss Out
In the study, researchers analyzed information from the 2003-2007 California Health Interview Surveys of 9,220 adolescents aged 12 to 17 who had a checkup in the last 12 months. The participants were asked whether they received screening for nutrition, physical activity, or emotional distress at their last checkup.
Overall, researchers found that obese teenagers reported higher screening rates than normal-weight teens in all three areas. For example, in 2007:
- Physical activity: 64% of obese teenagers received screening, compared with 59% of normal-weight teens.
- Nutrition: 63% of obese vs. 58% of normal-weight teens were screened.
- Emotional distress: 24% of obese teens vs. 23% of normal-weight teens received screening.
However, the study showed that teens who were overweight but not obese, who could benefit most from screening and preventive measures, did not have higher overall screening rates than normal-weight teens.
In addition, overall screening rates for all three measures declined from 2003 to 2007, the year in which the new recommendations were released.
Researchers say increased patient load, new immunization requirements, and insurance reimbursement issues may have contributed to the low obesity screening rates found by the study.
"Until we can provide pediatricians with the tools, reimbursement, and time to intervene in pediatric obesity, primary care remains a missed opportunity in the prevention of obesity," they write.