USPSTF recommends behavioral interventions for youth with high BMI

Key takeaways:

• Behavioral interventions can include education on healthy eating habits and exercise sessions.
• More research is needed on the long-term outcomes of weight loss medications in children and adolescents.

The U.S. Preventive Services Task Force has issued a draft recommendation encouraging physicians to provide or refer youth aged 6 years and older with a high BMI to intensive, comprehensive behavioral interventions.

The recommendation is a B grade. When finalized, it will replace the task force’s 2017 recommendation to screen for obesity in children and adolescents aged 6 years and older, which similarly advises clinicians to offer or refer patients to behavioral interventions.

“There are proven ways that clinicians can help the many children and teens who have a high BMI to manage their weight and stay healthy,” USPSTF member Katrina E. Donahue, MD, MPH, a professor and vice chair of research in the department of family medicine at the University of North Carolina at Chapel Hill, said in a press release. “Intensive behavioral interventions are effective in helping children achieve a healthy weight, while improving quality of life.”

According to the CDC, the prevalence of obesity among youth aged 2 to 19 years and 6 to 12 years was 19.7% and 20.7%, respectively, from 2017 to 2020.

In the draft evidence report, Elizabeth A. O’Connor, PhD, a behavioral health psychologist at Kaiser Permanente, and colleagues reviewed 50 randomized controlled trials (n = 8,798) on behavioral health interventions.

They found that such interventions resulted in small reductions in BMI and other weight-related outcomes after 6 to 12 months (mean difference = –0.7 kg/m²; 95% CI, –1 to –0.3).

The USPSTF noted that comprehensive behavioral interventions may include:

• education on healthy eating habits;
• supervised exercise sessions; and
• counseling on behavioral change techniques like problem solving and goal setting.

Effective interventions include at least 26 or more hours with a health care professional over 1 year, “which requires commitment from children and their families,” the release said.

While the task force reviewed evidence on weight loss medications, including liraglutide and semaglutide, it determined that more research is needed to fully understand their long-term impacts on health outcomes. Other research gaps include how BMI change affects overall and long-term health, and how clinicians can best talk to youth and families about weight loss.

“There are a variety of effective, evidence-based interventions that can help children and teens maintain a healthy weight,” task force member John M. Ruiz, PhD, a professor of clinical psychology in the department of psychology at the University of Arizona, said in the release. “Health care professionals should work with children and their families to find the intervention that is the best fit.”

Comments on the draft recommendation can be submitted here from Dec. 12 through Jan. 16.

References:

• Childhood obesity facts. https://www.cdc.gov/obesity/data/childhood.html. Accessed Dec. 7, 2023.
• Interventions for high body mass index in children and adolescents: An evidence update for the U.S. Preventive Services Task Force. https://www.uspreventiveservicestaskforce.org/uspstf/document/draft-evidence-review/high-body-mass-index-children-adolescents-interventions. Published Dec. 12, 2023. Accessed Dec. 12, 2023.
• Interventions for high body mass Index in children and adolescents: U.S. Preventive Services Task Force draft recommendation statement. https://www.uspreventiveservicestaskforce.org/uspstf/draft-recommendation/high-body-mass-index-children-adolescents-interventions. Published Dec. 12, 2023. Accessed Dec. 12, 2023.
• Obesity in children and adolescents: Screening. https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/obesity-in-children-and-adolescents-screening. Published June 20, 2017. Accessed Dec. 7, 2023.
• Task Force issues draft recommendation statement on interventions for high body mass index in children and adolescents. https://www.uspreventiveservicestaskforce.org/uspstf/sites/default/files/file/supporting_documents/high-bmi-children-adolescents-draft-rec-bulletin.pdf. Published Dec. 12, 2023. Accessed Dec. 12, 2023.