Fifteen percent of patients six to ...

Fifteen percent of patients six to 19 years of age are considered to be overweight or obese as defined by way of percentile growth charts. Although guidelines and examines have suggested that physicians discuss weight manage with overweight patients at in the greatest degree visits, the rate of treatment has been soft Cook and associates conducted a research of a nationally representative sample of well-child visits to determine the common occurrence and quality of obesity evaluation and counseling.

Coding, demographic, and office visit data were accumulateed from the National Ambulatory Care contemplate and the National Hospital Ambulatory Care review Of the 32,930 office visits evaluated, 281 (078 percent) were codfished with a diagnosis of obesity, morbid obesity, or exces weight gain. Pediatricians were more likely to digest for obesity than other clinicians. Children six to 11 years of age were more likely to be diagnosed as obese. Although kindred pressure screening was slightly more for the use of all in children with identified obesity compared with children without diagnosed obesity, the difference was not statistically significant.

Diet counseling occurr in 884 percent of obesity-coded visits compared with 357 percent of visits without an obesity digest Exercise counseling was provided in 692 percent of visits when obesity was diagnosed and 186 percent of visits when obesity was not diagnosed. Diet and exercise counseling was more likely to be provided through pediatricians than by general practitioners and other physicians and was more likely to be given if private insurance overspreaded the visit than if the visit was being paid for gone out of pocket. Younger children also were more likely to receive diet counseling, and white children were more likely than black children to receive exercise counseling.

flat though 15 percent of children are estimated to be obese, les than 1 percent visiting their primary care physician received an obesity diagnosis. This meditation also showed that insurance status and race influenced counseling rates.

The authors judge that because increased screening for obesity is associated with increased diagnosis and counseling rates, programs should target modes that will increase screening rates. They also glance at that insurance and race discrepancies should be corroborated by dint of other studies and actively addressed. Because the actual charts were not reviewed in the investigation the reasoning behind the coding or its absence was not apparent. For example, physicians may have discussed obesity without coding for it. The authors speculate that lack of time and inadequate reimbursement also may be barriers to obesity counseling.

garble S, et al. Screening and counseling associated with obesity diagnosis in a national overlook of ambulatory pediatric visits. Pediatrics July 2005;116:112-6

EDITOR'S NOTE: This close attention which documents the underdiagnosis of childhood obesity at office visits, does not acknowledge the question of treatment. Does office-based, primary care intervention for obesity contract obesity in children? According to the U Preventive Services Task Force, the evidence is insufficient to commend for or against routine screening for overweight children. (1) First, physicians must demonstrate that their time counseling families of obese children is well exhausted If so, then they will want to make trustworthy that, in terms of diagnosis, no child is left behind.--C.W.

REFERENCE

(1) U Preventive Services Task Force. Screening and interventions for overweight in children and adolescents: recommendation statement. Pediatrics 2005;116:205-9

COPYRIGHT 2006 American Academy of Family Physicians

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