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More research urged on treating childhood obesity

As the numbers on the scales continue to rise, questions persist about when and how to best intervene, including issues regarding bariatric surgery.

By Victoria Stagg Elliott, amednews staff. Aug. 22/29, 2005.

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Although the U.S. Preventive Services Task Force in July concluded that insufficient science exists to indicate the use of body mass index to track childhood obesity, some medical groups are urging physicians to do exactly that.

This disconnect is representative of the uncertainties that have led many physicians and childhood obesity experts to call for studies to determine the effectiveness of BMI screening in this population and what can be done after a doctor determines that weight could be an issue.

"What this means is we don't have the evidence that we ought to," said Virginia Moyer, MD, MPH, a member of the USPSTF and professor of pediatrics at the University of Texas, Houston. "This is a call to action."

For now, though, several medical societies are recommending that children be routinely screened for weight problems using BMI. The American Medical Association, for instance, adopted such policy at its Annual Meeting in June.

"Screening for overweight using BMI has a possible substantial benefit and little if any risk," said AMA Trustee Ronald M. Davis, MD.

The USPSTF, however, issued its recommendation last month, saying it could not endorse such efforts. The position reflected the panel's finding that evidence in support of BMI screening in this age group was imperfect because it does not always give clear-cut answers about whether an intervention is required.

"It's a terrible problem, and doctors need to be thinking about it," Dr. Moyer said. "Unfortunately, there's no evidence for an intervention that works in a primary care setting, and there's no evidence that screening itself makes a difference."