title: An increasing trend in health-care professionals notifying children of unhealthy weight status: NHANES 1999-2014.
abstract: Pediatric obesity prevalence remains at historically high levels. The objective of this study was to examine secular trends in the percentages of overweight/obese children who received notification from a health-care professional (HCP) about their unhealthy weight.
  
  
  
  We analyzed data of 25 570 (including 8639 overweight/obese) children aged 2-18 years collected from seven cross-sectional biennial surveys (National Health and Nutrition Examination Survey, 1999-2014), in which adolescents (16 years and older) and caregivers, mostly biological mothers, of children (2-15 years) were asked 'Has a doctor or other health professional ever told you that you (or your child) were overweight?'
  
  
  
  Approximately 90% of overweight/obese children visited HCPs at least once in the past 12 months, but only 22.12% (s.e.=1.92) in 1999 to 34.43% (2.35) in 2014 of the overweight/obese children were notified by HCPs about unhealthy weight. The biennial increase in odds of receipt of notification of unhealthy weight was 1.08 (95% confidence interval=(1.04-1.12)). Greater likelihood for receipt of notification was associated with being obese (odds ratio=5.03 (4.29-5.89) vs overweight); black (1.24 (1.06-1.46)) or Hispanic race/ethnicity (1.72 (1.45-2.04) vs white); female sex (1.22 (1.07-1.11) vs boys); and child's insurance status (1.31 (1.08-1.59) vs uninsured). There were increasing odds of being notified with increasing age: 1.00 (reference), 2.24 (2.06-2.62), 3.22 (2.50-4.13) and 4.87 (3.76-6.32) for children 2-5, 6-11, 12-16 and 16+ year old, respectively. The frequency of medical contact was linearly associated with an increased likelihood of being notified.
  
  
  
  Notification of child's unhealthy weight by HCPs increased significantly between 1999 and 2014, but the opportunity of clinical intervention remained substantially under-utilized.
authors.affiliation: Department of Community Health Behavior and Education, Georgia Southern University Jiann-Ping Hsu College of Public Health, Statesboro, GA, USA.
authors.forename: A R
authors.initials: AR
authors.lastname: Hansen
authors.affiliation: Department of Population Health, New York University School of Medicine, New York, NY, USA.
authors.forename: D T
authors.initials: DT
authors.lastname: Duncan
authors.affiliation: Department of Pediatrics, Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Columbia University Medical Center & New York-Presbyterian Morgan Stanley Children's Hospital; New York, NY, USA.
authors.forename: J A
authors.initials: JA
authors.lastname: Woo Baidal
authors.affiliation: Department of Epidemiology, Georgia Southern University Jiann-Ping Hsu College of Public Health, Statesboro, GA, USA.
authors.forename: A
authors.initials: A
authors.lastname: Hill
authors.affiliation: Department of Epidemiology, Georgia Southern University Jiann-Ping Hsu College of Public Health, Statesboro, GA, USA.
authors.forename: S C
authors.initials: SC
authors.lastname: Turner
authors.affiliation: Department of Epidemiology, Georgia Southern University Jiann-Ping Hsu College of Public Health, Statesboro, GA, USA.
authors.forename: J
authors.initials: J
authors.lastname: Zhang
mesh_terms: D000293:Adolescent; D015992:Body Mass Index; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D009749:Nutrition Surveys; D010290:Parents / Q000523:psychology; D063766:Pediatric Obesity / Q000175:diagnosis* / Q000517:prevention & control / Q000523:psychology; D010819:Physician's Role; D010818:Practice Patterns, Physicians' / Q000458:organization & administration / Q000706:statistics & numerical data*; D015995:Prevalence; D014481:United States / Q000453:epidemiology; D061217:Weight Reduction Programs