Published online July 1, 2005
PEDIATRICS Vol. 116 No. 1 July 2005, pp. 235-238 (doi:10.1542/peds.2005-0305)
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COMMENTARY

Screening for Overweight in Children and Adolescents: Where Is the Evidence? A Commentary by the Childhood Obesity Working Group of the US Preventive Services Task Force

Childhood Obesity Working Group, US Preventive Services Task Force

Virginia A. Moyer, MD, MPH

Department of Pediatrics
University of Texas Health Science Center
Houston, TX 77030

Jonathan D. Klein, MD, MPH

Department of Pediatrics
University of Rochester School of Medicine
Rochester, NY 14642

Judith K. Ockene, PhD

Division of Preventive and Behavioral Medicine
University of Massachusetts Medical School
Worcester, MA 01655

Steven M. Teutsch, MD, MPH

Outcomes Research and Management
Merck & Company, Inc
West Point, PA 19486-0004

Mark S. Johnson, MD, MPH

Department of Family Medicine
University of Medicine and Dentistry of New Jersey-New Jersey Medical School
Newark, NJ 07103

Janet D. Allan, PhD, RN, CS

School of Nursing
University of Maryland, Baltimore County
Baltimore, MD 21250

Abbreviations: USPSTF, US Preventive Services Task Force*

The first 20% of the full text of this article appears below.

The prevalence of childhood and adolescent overweight has tripled over the past 2 decades, and associations have been identified between dietary patterns, physical activity, sedentary behaviors, and overweight. Some believe that pediatricians can easily recognize an overweight or obese child or adolescent and that there are sufficient therapeutic options to offer these patients and their families.1 However, primary care clinicians face obese and overweight children, adolescents, and parents every day, and most clinicians rarely document overweight.

The American Academy of Pediatrics and American Academy of Family Physicians endorse universal screening using body mass index (BMI) and use of BMI growth curves to identify obese and overweight children. Physicians also seem to take high BMI more seriously than weight and height measures2; when documentation of high BMI occurs, screening, counseling, and referral rates for obese and overweight children and adolescents increase.3

Why then, does the US Preventive Services Task Force (USPSTF), in this issue of Pediatrics,4 find insufficient evidence to recommend for or against formally screening children and adolescents for obesity or overweight in the primary care setting? The answer is: the USPSTF adheres strongly to a policy of making recommendations (either for or against delivery of preventive services) only in the presence of sufficient evidence of adequate quality. The USPSTF cannot make a recommendation for or against screening even for a practice that may be supported by expert consensus or less rigorous evidence. It is important to note that the USPSTF did not recommend that primary care clinicians not weigh and measure children or ignore parental concerns . . . [Full Text of this Article]

Address correspondence to Program Director, USPSTF, Agency for Healthcare Research and Quality, 540 Gaither Rd, Rockville, MD 20850. E-mail: uspstf@ahrq.gov




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