LAUSR

In June 2017, the US Preventive Services Task Force (USPSTF) recommended clinicians screen for obesity in children and adolescents aged 6 years and older. ‘Overweight’ was defined as a body mass index (BMI) between the 85th and 94th percentiles, and ‘obesity’ as BMI ≥95th percentile. Clinicians were recommended to refer obese children for comprehensive, behavioural weight reduction interventions. This statement was accompanied by three separate editorial comments. The USPSTF found intensive behavioural interventions (>26 contact hours) in obese children and adolescents (6 years and older) result in improvements in weight status, at least for 12 months. A hallmark of these family-based behavioural treatments is that both parents and children are targeted for eating, activity and weight changes. A reduction in BMI z score (a standardised measure of BMI based on ageand sex-specific norms) in the range of 0.20–0.25 was considered clinically important. In the more intensive randomised trials (i.e. >26 contact hours), intervention groups showed absolute reductions in BMI z score of 0.20 or greater. Adherence is clearly a major issue; in the included trials, 68–95% of participants completed all sessions. The USPSTF concludes with moderate certainty that the net benefit of screening for obesity, and referring them for comprehensive, intensive behavioural interventions, is moderate.