US panel recommends intervention in obese children as young as 6 years old

A closeup of a beam scale in New York. US health officials from the Centers for Disease Control and Prevention expanded growth charts in Dec 2022 to include a body mass index of 60 — up from previous charts that stopped at a BMI of 37. (Photo: AP/Patrick Sison)

In 2017, the government-backed US Preventive Services Task Force recommended that screening begin at age six.

The panel stated that research has since shown the effectiveness intensive behavioral interventions, defined as at least a minimum of 26 hours of counseling with one or two health professionals for improving quality of life and achieving a healthy body weight for children and teenagers. The panel did not give a specific timeframe for the recommendation.

The USPSTF’s new advice does not cover the use of medication such as Novo Nordisk Wegovy (approved for children aged 12 years and older) or surgery.

The Task Force reviewed the evidence regarding weight loss medication but concluded that further research is required to fully understand long-term health effects of these medications.

Katrina Donahue, a task force member from the University of North Carolina School of Medicine, explained that the behavioural interventions will consist of “a package”, which includes physical activity and support for behavior change as well as education on healthy eating.

Donahue said that because local resources differ, interventions “will look different in different cities.”

The panel reviewed data from 58 controlled randomized trials that involved more than 10,000 kids and found these interventions to be effective, “as soon as the child has at least 26 total hours of contact with professionals,” Donahue stated.

INTERVENTION HELPED CHILDREN LOSE WEIGHT

The USPSTF gave intensive interventions a “grade” B, which means that there is a high degree of certainty they will have a moderate or even a moderately positive effect. The trials saw an average weight loss of 2 to 3 kg, and the reductions lasted at least a year.

The body mass index (a ratio of height to weight) of children and adolescents up to age 19 must be higher than 95% of other youngsters of the age and gender.

According to the US Centers for Disease Control and Prevention, nearly one fifth of US children and teenagers fall into this category.

The American Academy of Pediatrics’ (AAP) guidelines include lifestyle support, including “face-to face, family-based multicomponent treatment for a period of 3 to 12 months.”

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