Effectiveness of Pediatric Weight-Related Counseling and Screening in a National Sample of Children and Youth

Introduction: Childhood obesity is a major public health concern, with over a third of US children overweight or obese. Pediatric prevention measures to prevent overweight and obesity include anticipatory guidance regarding healthy diet and exercise, and BMI screening. However, it is uncertain whether this counseling or screening has an effect on a child’s weight.

Methods: Data from the 2008-2010 Medical Expenditures Panel Survey were analyzed for children and youth ages 6-17 years (n=9,746) to test associations between receipt of weight-related counseling or screening and body mass index (BMI) classification one year later in a national sample of children and youth.

Results:  The proportion of children who received exercise counseling and diet counseling increased with the child’s weight class in a dose response relationship. Fewer than half of children received all recommended counseling and screening: only 34% of those classified as normal weight, 40% of those classified as overweight, and 46% of those classified as obese. Counseling and screening were marginally predictive of the child’s weight classification one year later (AOR O.08). Significant predictors of weight status included baseline BMI (AOR 0.59) and maternal weight classification (AOR 0.35).

Discussion: To promote healthy weight in children, public health interventions aimed at maternal-child dyads may prove more effective than pediatric-provider counseling and screening.