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A missed opportunity to reduce adolescent obesity?

As Ben Franklin famously said, an ounce of prevention is worth a pound of cure. Except, it seems, when it comes to counseling overweight adolescents.

A study conducted by Chad Meyerhoefer, associate professor of economics, and two other researchers found that overweight children are much less likely to receive counseling from medical providers than their peers who are already obese.

“The findings are important because obesity is easier to prevent than to treat, and overweight children are most at risk of becoming obese,” Meyerhoefer says. “Physician counseling for those that are at-risk is most likely to result in positive behavioral change.”

The study, published in the journal Pediatrics this month, also found that medical providers are more likely to give advice on the benefits of healthy eating and exercise to children from higher income families.

Meyerhoefer teamed with Lan Liang of the Agency for Healthcare Research and Quality and Justin Wang of the Worcester Polytechnic Institute to conduct the first study to examine obesity related counseling to adolescents over an extended period of time. The researchers reviewed data from the 2001-07 Medical Expenditure Panel Survey of adolescents 11 to 17 years old who reported at least one health provider visit in the previous 12 months.

Children are considered obese if their body mass index (BMI) is greater than the 95th percentile of historical BMI distribution, determined before the current obesity epidemic. Children are overweight if their BMI is between the 85th and 95th percentile. Current clinical guidelines recommend that health care providers evaluate a pediatric patient’s diet and activity levels at each well child visit, and counsel children in the obese and overweight BMI range to improve their diet and increase their level of physical activity. 

The researchers also looked at how socioeconomic factors and access to health care affect whether adolescents receive counseling. Their findings indicated that advice to eat healthy and exercise was more likely provided to adolescents who lived in the northeast, were from higher income households, had parents with at least some college education, and had a usual source of medical care.

Over the past four decades, the level of obese and overweight children and adolescents has risen significantly. In 2008, more than one-third of children and adolescents in the United States were overweight or obese, according to the CDC.  Despite increasing awareness of the problem, Meyerhoefer contends that “more needs to be done to encourage health providers to counsel their adolescent patients on diet and physical activity. While additional training might help, it may be necessary to change the structure of physician reimbursements to better reflect the time and effort required to provide this type of counseling.”

For the full research study, read: Obesity Counseling by Pediatric Health Professionals: An Assessment Using Nationally Representative Data

Photo by Douglas Benedict

Posted on Monday, June 04, 2012
Chad Meyerhoefer, associate professor of economics, says overweight children would benefit most from physician counseling because they "are most at risk of becoming obese."
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