The U.S. Preventive Services Task Force (USPSTF) has released new draft recommendations advising primary care doctors to offer or refer patients aged 6 years and older with obesity to behavioral counseling programs aimed at curbing excessive weight gain in youth.
New Guidelines Aim to Curb Rising Obesity Rates
The proposed recommendations aim to address the growing epidemic of obesity among America’s youth, which can pave the way for myriad health issues down the line. According to the USPSTF, about 20.6% of children and adolescents aged 2-19 have obesity, with higher rates among specific populations.
If finalized, these would be the first USPSTF recommendations specifically targeting weight management in children and teens. The guidance stresses the importance of early and intensive intervention, encouraging doctors to screen young patients for obesity starting at age 6 and offer or connect families with treatments shown to produce meaningful weight loss.
Behavioral Programs Endorsed for Kids Over 6
Specifically, the USPSTF recommends clinicians offer or refer patients aged 6 years or older with obesity to intensive, multicomponent behavioral intervention programs. These intensive counseling and lifestyle change programs can greatly improve outcomes compared to standard care or less intensive treatments.
The recommended programs focus on:
- Improving nutrition and healthy eating
- Increasing physical activity
- Decreasing sedentary behavior
- Strategies like stimulus control, self-monitoring, and positive reinforcement to help make lifestyle changes stick
Programs endorsed by USPSTF involve 26 or more hours of intervention over a 2-12 month timeframe. Depending on the child and family’s needs, they may take place one-on-one or with a group in-person, online, by phone, or through a combination of methods.
Weight Loss of 3-7% Seen in High-Quality Studies
The draft guidance is based on a review of 53 trials evaluating intensive behavioral interventions. Children and teens who participated saw significant improvements in weight status, including an average weight loss of 3-7% over 6-12 months.
Other benefits observed:
- Decreased BMI
- Improved cardiometabolic risk factors
- Enhanced quality of life
- Minimal harms
Additionally, a cost-effectiveness analysis found intensive multicomponent behavioral interventions for obesity in youth are reasonably priced healthcare strategies.
Widespread Support from Health Groups
Numerous medical groups have endorsed the proposed recommendations, including the Endocrine Society, Obesity Medicine Association, Obesity Action Coalition, American Academy of Pediatrics, and The Obesity Society.
Experts widely agree earlier intervention offers the best chance to curb excessive weight gain in childhood that often carries on into adulthood. Childhood obesity can negatively impact nearly every organ system and is linked to a number of health risks:
|Obese youth have greater risk factors for cardiovascular disease like high blood pressure and cholesterol
|Up to 1 in 5 teens with obesity develop prediabetes
|Children with obesity have 2-3 times higher asthma rates
|Excess weight strains growing joints and bones
|Obesity can impact self-esteem and lead to depression/anxiety
By addressing obesity early through intensive lifestyle modification programs, doctors hope to circumvent myriad medical complications down the line.
Barriers to Access Remain
If finalized, advocates caution guidelines alone will not curb climbing childhood obesity rates across diverse populations. Systemic barriers around cost, transportation, parental leave from work, and tailoring programs to different cultures and languages will need to be addressed.
The Centers for Disease Control and Prevention reports obesity affects 25.6% of Hispanic youth, 24.8% of non-Hispanic Black youth, 16.6% of non-Hispanic White youth, and 11% of non-Hispanic Asian youth.
Lower income areas often have higher obesity rates too. Improving accessibility through insurance coverage, telehealth options, and local community partnerships will be key for guidance adoption.
Final Recommendation Expected in Coming Year
The USPSTF draft recommendations around screening and behavioral interventions for pediatric patients with obesity are open for public comment through January 9th.
After reviewing feedback, the Task Force will issue a final recommendation statement in 2024 on what preventive steps doctors should take to curb rising childhood obesity rates through early, intensive intervention approaches.
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