July 18th, 2011
12:27 PM ET
Government advisory panels today say doctors should talk to their teen patients about weight, about how active they are, their emotions and what they’re eating. But a study in the current issue of Pediatrics found that wasn’t happening for the group that perhaps could have benefited from it most.
Teens who were already obese were more likely than normal-weight teens to receive the screenings. But those verging on obesity were not.
"The adolescents who are not yet obese, but are overweight, they're not getting that extra attention that they should be getting based on recommendations- that's an issue, that's a problem," said Dr. Carolyn Jasik, study author and assistant professor of pediatrics at University of California, San Francisco. She is also an adolescent obesity specialist.
"I think providers need to know that it's very important to target this middle group of overweight kids and make sure that they get attention when there are early warning signs," she added. "The problem is if you looked at a child who is overweight, you may not be able to tell by just looking at them that there's a concern for their health. You need to measure the weight and compare it to standards for their age."
Jasik is referring to the adolescent's BMI, or body mass index. Weight is considered normal if less than the 85th percentile. An overweight child is between the 85th and 94th percentiles, and an obese child is equal to or greater than the 95th percentile.
A previous, recent study found that only slightly over half of patients had their BMI calculated at the visit.
The current study included more than 9,000 adolescents, between the ages of 12 and 17. The self-reported information was gathered from young people in California, all of whom reported an examination within the last year. Participants included both males and females, and a variety of races and ethnicities.
They were asked whether they had talked with their physician about exercise, diet and emotions or moods.
The results showed a trend that screening rates for all areas dropped between 2003 and 2007.
Screenings for mood and emotional distress had the lowest reported rates. Less than a quarter of the adolescents said they talked to their physician about emotions during their last visit.
"Depression, anxiety, body image- those are major issues for overweight and obese kids... it's just a really big missed opportunity," Jasik said.
"Providers really need to be talking to kids about those things if they are overweight or obese..because often, [these things] are barriers to changing your health behaviors," she added.
Jasik had this advice for parents about what to ask the physician:
*Do I need to be concerned about my child's weight?
*Can you talk to us about healthy diet and activity?
*[Can you] help us find things in our community that will allow us to be more active and eat better?
She says that study didn’t determine why the teens were not getting the needed attention, but she speculated that it might be due to the time it takes for the physician to offer these services, proper reimbursement for them, and sufficient resources and programs for where to refer kids who need intervention.
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