Are childhood obesity interventions effective?

Two steps forward, one step back — that pretty much sums up the latest move against this country’s snowballing childhood obesity crisis.

This one comes courtesy of the U.S. Preventive Services Task Force (USPSTF). And unfortunately, it’s cut from the same tired mold I’ve come to expect from so-called government “experts.”

Because let’s face the facts — if the government knew what they were talking about, would we even be in this situation in the first place?

Even without the dubious track record, though, this most recent recommendation would give me pause. Because while it advises doctors to screen kids ages six and older for obesity, its proposed solution is — get this — a referral to a 26-hour behavioral intervention program for weight loss.

Don’t get me wrong. I’m glad that harmful excuses like “she’s just big-boned” or “he’s going to grow out of it” aren’t going to fly anymore.

Because they’re simply not true.

And, trust me, if the doctor and the parents can see there’s a problem, the child can see it, too. As an overweight child, I was acutely aware that I was different from the other children. Obese children recognize this — they just don’t know what to do about it. Especially when everyone tends to ignore (or make excuses for) the elephant in the room.

This is why they need support. Because as the USPSTF itself notes, obesity places just as much burden on the health of kids and teens as it does on adults — and if you start out life with extra weight, chances are much higher that you’ll struggle with obesity in adulthood, too.

It’s a horrific, vicious cycle — and the sooner it’s broken, the better.

But unfortunately, I don’t think the USPSTF’s plan is going to do the trick. I’d really like to know how they came up with the very specific timeframe they assigned to their pediatric weight loss program.

Like I said, I was an obese 6-year-old once. It’s taken me my entire life to learn how to stay lean and healthy. So I’m really not sure how any “behavioral intervention program” is going to achieve the same outcome in a mere 26 hours.

Still, this is the magic number they settled on — citing that interventions featuring 26 hours or more of “training” are the ones most likely to deliver successful weight loss that’s maintained for at least a year.

These types of behavioral interventions typically include a number of components — most often, some sort of combination of nutrition and exercise counseling. Education (like how to read food labels) and guidance on limiting screen time, setting goals, and navigating common roadblocks are also common.

All these suggestions look great on paper. But from where I sit, reducing the complex weight loss journey to a 26-hour “boot camp” seems destined to end in failure.

Successful weight management isn’t like filling a prescription at the pharmacy. It takes a village, as they say — often in the form of sustained support from the child’s family and community at large.

The sad fact is, most obese kids simply don’t have access to this kind of support. (And even if they did, they wouldn’t necessarily have the insurance to pay for it.)

It also defeats the purpose for the USPSTF to set the bar for referral to this program at a BMI in the 95th percentile. That, to me, is the very definition of “too little, too late.”

Imagine what could be accomplished if interventions were offered to children in the 60th percentile — or any percentile, for that matter. Because every child needs to learn how to care for their body.

It’s called “prevention” — something that you’d think the USPSTF would know a little more about.

 

Source:

http://www.medscape.com/viewarticle/881829

 


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