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Clinicians are more likely to counsel youth diagnosed with obesity about diet and exercise

About 15 percent of children and adolescents in the United States are either overweight or obese. A new study finds that when obesity is diagnosed in children aged 2 to 18 years, clinicians are more likely to counsel them and their parents about diet and exercise.

Researchers, supported in part by the Agency for Healthcare Research and Quality (HS13901), examined blood pressure screening and diet and exercise counseling for children aged 2 to 18 years who were diagnosed with obesity during well-child visits. They used data from the National Ambulatory Medical Care Survey and the National Hospital Ambulatory Medical Care Survey from 1997-2000. Of the 39,930 ambulatory visits by this group during the study period, clinicians diagnosed obesity at less than 1 percent of all visits. When patients were diagnosed with obesity at well-child visits, clinicians assessed their blood pressure and counseled them about diet and exercise more often than they did for patients at visits where obesity was not diagnosed (61 vs. 44 percent, 88 vs. 36 percent, and 69 vs. 19 percent, respectively).

Factors associated with diet counseling at well-child visits were diagnosis of obesity, being seen by pediatricians, ages 2 to 5 years compared with 12 to 18 years, and self-pay compared with private insurance visit. Factors associated with exercise counseling were similar to those for diet counseling, but exercise counseling occurred half as often in visits by black youths than it did in visits with white youths.

See "Screening and counseling associated with obesity diagnosis in a national survey of ambulatory pediatric visits," by Stephen Cook, M.D., Michael Weitzman, M.D., Peggy Auinger, M.S., and Sarah E. Barlow, M.D., M.P.H., in the July 2005 Pediatrics 116(1), pp. 112-116.

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