title: Identification and counseling for obesity among children on psychotropic medications in ambulatory settings.
abstract: OBJECTIVE
  To examine identification and counseling for obesity at pediatric office visits associated with psychotropic medications.
  
  
  METHODS
  Analysis of ambulatory care visits by children 2-17 years in the National Ambulatory Medical Care Surveys and outpatient component of the National Hospital Ambulatory Medical Care Surveys from 2005 to 2008. Physician identification of obesity was determined using ICD-9 CM diagnostic codes.
  
  
  RESULTS
  In 2005-2008, there were 38,539 pediatric ambulatory care visits weighted to represent 600 million pediatric visits nationally. Psychotropic medications were associated with 5.2% of visits. The prevalence of overweight/obesity (BMI ≥ 85th%tile) was 15.9% for visits without psychotropic medication, 19.4% and 16.8% for visits associated with nonobesogenic and obesogenic psychotropic medications, respectively. Controlling for age, gender, and BMI, obesity was more likely to be identified at visits associated with psychotropic medications (OR 5.2, 95% CI 3-8.8), among females (OR 1.6, 95% CI 1.1-2.3) and non-Hispanics (OR 1.5, 95% CI 1.0-2.4). At visits with psychotropic medications, dietary counseling was provided at 11.4%, while blood pressure and cholesterol screening were obtained at 6.9% and 6.8% of these visits, respectively.
  
  
  CONCLUSIONS
  Our results indicate suboptimal identification and counseling for obesity children who are prescribed psychotropic medications, despite their increased risk for weight gain.
authors.affiliation: Center for Healthy Weight and Nutrition, Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH, 43205, USA. ihuoma.eneli@nationwidechildrens.org
authors.forename: Ihuoma U
authors.initials: IU
authors.lastname: Eneli
authors.forename: Wei
authors.initials: W
authors.lastname: Wang
authors.forename: Kelly
authors.initials: K
authors.lastname: Kelleher
mesh_terms: D000293:Adolescent; D000553:Ambulatory Care / Q000706:statistics & numerical data; D002318:Cardiovascular Diseases / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D003376:Counseling / Q000379:methods*; D003430:Cross-Sectional Studies; D004032:Diet; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D008297:Male; D009819:Office Visits / Q000706:statistics & numerical data; D010045:Outpatients / Q000706:statistics & numerical data; D063766:Pediatric Obesity / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy*; D015995:Prevalence; D011619:Psychotropic Drugs / Q000627:therapeutic use*; D015203:Reproducibility of Results; D015430:Weight Gain
chemical_list: D011619:Psychotropic Drugs