Issues in obesity monitoring, screening and subsequent treatment.
OBJECTIVE
Despite intense policy, media and research interest, childhood obesity rates continue to rise in most countries. Screening may seem a logical response to a situation in which obesity does not usually resolve spontaneously, yet most obese children do not present for treatment. This article explores recent evidence for and against monitoring and screening of children's BMI.


RESULTS
Whether conducted in primary care or school settings, population screening of children's BMI can be feasible, acceptable and not intrinsically harmful. However, it incurs a substantial cost, and randomized controlled trials do not suggest that it improves BMI outcomes. Population trends in BMI are more complex than a simple rise in obesity; birth cohorts with higher rates of childhood overweight are not inevitably more overweight as young adults. The consequences of a concomitant increase in thinness are uncertain.


CONCLUSIONS
Systematic monitoring of BMI is essential, but need not be continuous, and could involve representative samples rather than all individuals in a population. In contrast, BMI screening cannot be recommended until more effective management becomes available for overweight and mildly obese children. Research into prevention and intervention should, therefore, be prioritized over population screening at this point in time.
Wake
Melissa
M
Centre for Community Child Health, Royal Children's Hospital and Murdoch Childrens Research Institute, Department of Paediatrics, The University of Melbourne, Parkville, Melbourne, Victoria, Australia. melissa.wake@rch.org.au
D000293:Adolescent; D015992:Body Mass Index; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods*; D009765:Obesity / Q000175:diagnosis* / Q000517:prevention & control / Q000628:therapy*; D050177:Overweight / Q000175:diagnosis / Q000517:prevention & control / Q000628:therapy