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BMI intervention tool helps parents detect childhood obesity
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Using Fitwits, an approach used during well-child visits to prevent obesity, improved parents’ ability to recognize their child’s correct BMI category, according to a recent study.
“This Fitwits BMI study is a response to the growing ‘norm’ of childhood obesity and the concurrent fading parental recognition of a child’s excess weight,” Bethany A. Edwards, MD, from the University of Pittsburgh Medical Center Urgent Care, and colleagues wrote in the Journal of the American Board of Family Medicine. “Physicians need to help parents understand that their child is overweight or obese, and then help them take action.”
Edwards and colleagues enrolled 140 parents and their children aged 9 to 12 years presenting for well-child care scheduled with 53 Fitwits-trained physicians. All parent-child pairs used the Fitwits tool to guide a conversation about BMI, nutrition, activity and portion sizes. The researchers assessed parents’ awareness of their child’s BMI status, their satisfaction with the discussion and the child’s longitudinal BMI percentile trajectory over 12 months.
Before the intervention, 50% of parents identified the correct BMI category designations, with 34.5% and 4.4% correctly noticing overweight and obese status, respectively. The results showed that after the Fitwits intervention, 60.6% correctly identified their child’s weight status, with 51.7% and 24.4% correctly observing overweight and obese categories, respectively. The investigators also saw that most of the parent-child pairs commented positively on the Fitwits program, and 75.8% of pairs selected goals corresponding to Fitwits card suggestions.
“Continuing underrecognition or acknowledgement of overweight/obese children and some healthy children was noted. This highlights the difficulties of educating parents to identify BMI status in the new ‘normal’ environment of heavier children, even with a dedicated intervention,” Edwards and collages wrote. “Further results pending analysis include longitudinal 12-month surveillance of current BMI category choices and BMI trajectories, with an opportunity to improve with the use of Fitwits at 3 follow-up visits.” – by Savannah Demko
Disclosure: Edwards reports no relevant financial disclosures.
Perspective
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Caroline M. Apovian, MD, FACP, FACN
Pediatric, adolescent and adult rates of overweight and obesity in the United States and worldwide have reached epidemic proportions. While adult obesity relief is focused on treatment, pediatric obesity relief should be focused on prevention. A study such as this, which targets education of parents towards BMI in children, can also educate the physician in how to approach the patient and family. If health care has a chance to at least halt this epidemic, it has to start in the physician's office. Assessment of dietary patterns and physical activity and suggestions for lifestyle changes are the next step after assessment of BMI in children who meet the at-risk categories. Let us not, however, blame the parents for an epidemic that surely started with a societal, environmental, economic and perhaps biologic trend toward adiposity. We all need to be educated — parents, physicians and allied health, government and community as well.
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