Parental Recall of Doctor Communication of Weight Status: National Trends From 1999 Through 2008

To examine time trends in parental reports of health professional notification of childhood overweight over the last decade and to determine the characteristics most associated with such notification

Is childhood overweight a special health care need?

Background: Children with special health care needs (CSHCN) are those who: (1) have or are at increased risk for a chronic medical condition and (2) require more health care than children generally. Because the CSHCN designation is intended to improve access to care, including securing a medical home and public programs that address the health needs of CSHCN, an important policy issue is whether childhood overweight meets both criteria that define CSHCN. Methods: This is a cross-sectional analysis of two nationally representative data sources, the 2001-2002 National Health and Nutrition Examination Survey (NHANES) and the 2002 Medical Expenditure Panel Survey (MEPS). Both surveys are used to examine the relationship between overweight and health status. NHANES is used to examine the relationship between overweight and three chronic conditions: dyslipidemia, dysglycemia, and hypertension. MEPS is used to examine the relationship between overweight, health care use and expenditures, and a medical home. Results: Overweight children, compared to healthy-weight children, have significantly increased risk for high total cholesterol, high or borderline LDL cholesterol, low HDL cholesterol, high triglycerides, high fasting glucose, high glycohemoglobin, and high systolic blood pressure. Overweight children report worse health status than healthy-weight children. Compared to healthy weight children, overweight children are less likely to have any health care expenditure; this difference does not remain after adjusting for socioeconomic status. Having a medical home tends to be associated with greater health care use and expenditures, though not consistently. Conclusions: These findings suggest that overweight children may meet the definition of CSHCN. They are clearly at increased risk for chronic health conditions that require more health care than that needed by healthy-weight children. Including overweight children under the umbrella of CSHCN is one potential strategy for improving access to care and enhancing health care resources available to overweight children. Such strategies to address overweight during childhood are critical to prevent chronic conditions, improve health status, and reduce health care expenditures, both during childhood and into adulthood

Prevalence and Trends in Obesity and Severe Obesity Among Children in the United States, 1999-2012

IMPORTANCE: Childhood obesity is the focus of public health efforts and accurate estimates of the prevalence and severity of obesity are needed for policy decisions and directions for future research. OBJECTIVE: To examine the prevalence of obesity and severe obesity over time for 14 years of the continuous National Health and Nutrition Examination Survey, 1999 to 2012, and to examine differences in the trends by age, race/ethnicity, and sex. DESIGN, SETTING, AND PARTICIPANTS: Representative sample (N = 26 690) of children in the United States, ages 2 to 19 years, in repeated cross-sections of the National Health and Nutrition Examination Survey, 1999 to 2012. MAIN OUTCOMES AND MEASURES: Prevalence of overweight (body mass index [BMI] ≥ 85th percentile), obesity (BMI ≥ 95th percentile for age and sex), class 2 obesity (BMI ≥ 120% of the 95th percentile or BMI ≥ 35), and class 3 obesity (BMI ≥ 140% of the 95th percentile or BMI ≥ 40). RESULTS: From 2011 to 2012, 17.3% (95% CI, 15.3-19.3) of children in the United States aged 2 to 19 years were obese. Additionally, 5.9% (95% CI, 4.4-7.4) of children met criteria for class 2 obesity and 2.1% (95% CI, 1.6-2.7) met criteria for class 3 obesity. Although these rates were not significantly different from 2009 to 2010, all classes of obesity have increased over the last 14 years. CONCLUSIONS AND RELEVANCE: Nationally representative data do not show any significant changes in obesity prevalence in the most recently available years, although the prevalence of obesity may be stabilizing. Continuing research is needed to determine which, if any, public health interventions can be credited with this stability. Unfortunately, there is an upward trend of more severe forms of obesity and further investigations into the causes of and solutions to this problem are needed

Healthy for Now? A Cross-Sectional Study of the Comorbidities in Obese Preschool Children in the United States

Examine health of preschoolers by BMI status

Racial Disparities Across Provider Specialties in Opioid Prescriptions Dispensed to Medicaid Beneficiaries with Chronic Noncancer Pain

Chronic pain affects both psychological and physical functioning, and is responsible for more than $60 billion in lost productivity annually in the United States. Although previous studies have demonstrated racial disparities in opioid treatment, there is little evidence regarding disparities in treatment of chronic non-cancer pain (CNCP) and the role of physician specialty

Behaviors and motivations for weight loss in children and adolescents: Weight Loss Behaviors and Motivations in Children

Examine the association between weight loss behaviors and motivations for weight loss in children and adolescents and the association of weight status with these behaviors and motivations in a nationally representative sample

Source of Parental Reports of Child Height and Weight during Phone Interviews and Influence on Obesity Prevalence Estimates among Children Aged 3–17 Years

We compared parental reports of children’s height and weight when the values were estimated vs. parent-measured to determine how these reports influence the estimated prevalence of childhood obesity

Cholesterol Curves to Identify Population Norms by Age and Sex in Healthy Weight Children

Develop clinically applicable charts of lipid values illustrating fluctuations throughout childhood and by sex among healthy weight children

Physical Activity and BMI in a Nationally Representative Sample of Children and Adolescents

To examine objectively measured physical activity levels by age, sex, and BMI for children and adolescents in a nationally representative sample

Pass the popcorn: "obesogenic" behaviors and stigma in children's movies.

OBJECTIVE: To determine the prevalence of obesity-related behaviors and attitudes in children's movies. METHODS: A mixed-methods study of the top-grossing G- and PG-rated movies, 2006-2010 (4 per year) was performed. For each 10-min movie segment, the following were assessed: 1) prevalence of key nutrition and physical activity behaviors corresponding to the American Academy of Pediatrics obesity prevention recommendations for families; 2) prevalence of weight stigma; 3) assessment as healthy, unhealthy, or neutral; 3) free-text interpretations of stigma. RESULTS: Agreement between coders was >85% (Cohen's kappa = 0.7), good for binary responses. Segments with food depicted: exaggerated portion size (26%); unhealthy snacks (51%); sugar-sweetened beverages (19%). Screen time was also prevalent (40% of movies showed television; 35% computer; 20% video games). Unhealthy segments outnumbered healthy segments 2:1. Most (70%) of the movies included weight-related stigmatizing content (e.g., "That fat butt! Flabby arms! And this ridiculous belly!"). CONCLUSIONS: These popular children's movies had significant "obesogenic" content, and most contained weight-based stigma. They present a mixed message to children, promoting unhealthy behaviors while stigmatizing the behaviors' possible effects. Further research is needed to determine the effects of such messages on children