Skip to main content
NCBI home page
CMAJ : Canadian Medical Association Journal logoLink to CMAJ : Canadian Medical Association Journal
. 1994 Mar 15;150(6):871–879.

Periodic health examination, 1994 update: 1. Obesity in childhood. Canadian Task Force on the Periodic Health Examination.

PMCID: PMC1486730  PMID: 8131120

Abstract

OBJECTIVE: To update the 1979 Canadian Task Force on the Periodic Health Examination recommendation on screening for childhood obesity by reviewing any new evidence concerning health risks in childhood and adulthood, and effective preventive or therapeutic interventions. OPTIONS: Detection: routine measurement of height and weight, use of skinfold thickness measurements, calculation of body mass index (BMI). Intervention: diet, exercise, behaviour modification and comprehensive family-based weight-reduction programs. Components of these interventions could be offered routinely or reserved for children and families who perceive obesity to be a present or potential problem. OUTCOMES: The task force reviewed the probability of obese children become obese adults as a risk factor for adult heart disease and overall related illness and death in adult life as well as obesity as a risk factor for physical and psychologic illness in childhood. EVIDENCE: A MEDLINE search for relevant articles published between January 1981 and February 1991 was undertaken. VALUES: The task force's evidence-based rules for recommendations were used. BENEFITS, HARMS AND COSTS: If weight reduction in childhood were shown to prevent physical or psychologic illness in childhood, or illness and death in adult life, screening and treatment should be recommended. Screening for obesity may cause anxiety on the part of the child and family; malnutrition in children as a result of parents becoming overly anxious about the health risks of obesity has been reported. Most weight reduction programs have limited long-term effectiveness and can be costly. RECOMMENDATIONS: There is insufficient evidence of short-term or long-term benefits from screening for or treatment of childhood obesity to recommend such screening or recommend against it. There is fair evidence to recommend against very-low-kilojoule diets for preadolescents. There is insufficient evidence to recommend for or against exercise programs or intensive family-based programs for most obese children. VALIDATION: These recommendations are similar to those of the American Academy of Pediatrics and the US Preventive Services Task Force. SPONSOR: These guidelines were developed and endorsed by the Canadian task force, which is funded by Health Canada.

Full text

PDF
871

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Abraham S., Collins G., Nordsieck M. Relationship of childhood weight status to morbidity in adults. HSMHA Health Rep. 1971 Mar;86(3):273–284. [PMC free article] [PubMed] [Google Scholar]
  2. Amador M., Ramos L. T., Moroño M., Hermelo M. P. Growth rate reduction during energy restriction in obese adolescents. Exp Clin Endocrinol. 1990 Sep;96(1):73–82. doi: 10.1055/s-0029-1210991. [DOI] [PubMed] [Google Scholar]
  3. Aristimuño G. G., Foster T. A., Voors A. W., Srinivasan S. R., Berenson G. S. Influence of persistent obesity in children on cardiovascular risk factors: the Bogalusa Heart Study. Circulation. 1984 May;69(5):895–904. doi: 10.1161/01.cir.69.5.895. [DOI] [PubMed] [Google Scholar]
  4. Ballew C., Liu K., Levinson S., Stamler J. Comparison of three weight-for-height indices in blood pressure studies in children. Am J Epidemiol. 1990 Mar;131(3):532–537. doi: 10.1093/oxfordjournals.aje.a115528. [DOI] [PubMed] [Google Scholar]
  5. Brook C. G., Huntley R. M., Slack J. Influence of heredity and environment in determination of skinfold thickness in children. Br Med J. 1975 Jun 28;2(5973):719–721. doi: 10.1136/bmj.2.5973.719. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Burns T. L., Moll P. P., Lauer R. M. The relation between ponderosity and coronary risk factors in children and their relatives. The Muscatine Ponderosity Family Study. Am J Epidemiol. 1989 May;129(5):973–987. doi: 10.1093/oxfordjournals.aje.a115229. [DOI] [PubMed] [Google Scholar]
  7. Börjeson M. The aetiology of obesity in children. A study of 101 twin pairs. Acta Paediatr Scand. 1976 May;65(3):279–287. doi: 10.1111/j.1651-2227.1976.tb04887.x. [DOI] [PubMed] [Google Scholar]
  8. Dietz W. H., Jr, Hartung R. Changes in height velocity of obese preadolescents during weight reduction. Am J Dis Child. 1985 Jul;139(7):705–707. doi: 10.1001/archpedi.1985.02140090067031. [DOI] [PubMed] [Google Scholar]
  9. Epstein L. H., McCurley J., Valoski A., Wing R. R. Growth in obese children treated for obesity. Am J Dis Child. 1990 Dec;144(12):1360–1364. doi: 10.1001/archpedi.1990.02150360086029. [DOI] [PubMed] [Google Scholar]
  10. Epstein L. H., Valoski A., Koeske R., Wing R. R. Family-based behavioral weight control in obese young children. J Am Diet Assoc. 1986 Apr;86(4):481–484. [PubMed] [Google Scholar]
  11. Epstein L. H., Valoski A., Wing R. R., McCurley J. Ten-year follow-up of behavioral, family-based treatment for obese children. JAMA. 1990 Nov 21;264(19):2519–2523. [PubMed] [Google Scholar]
  12. Epstein L. H., Wing R. R. Behavioral treatment of childhood obesity. Psychol Bull. 1987 May;101(3):331–342. [PubMed] [Google Scholar]
  13. Epstein L. H., Wing R. R., Koeske R., Andrasik F., Ossip D. J. Child and parent weight loss in family-based behavior modification programs. J Consult Clin Psychol. 1981 Oct;49(5):674–685. doi: 10.1037//0022-006x.49.5.674. [DOI] [PubMed] [Google Scholar]
  14. Epstein L. H., Wing R. R., Koeske R., Valoski A. Effects of diet plus exercise on weight change in parents and children. J Consult Clin Psychol. 1984 Jun;52(3):429–437. doi: 10.1037//0022-006x.52.3.429. [DOI] [PubMed] [Google Scholar]
  15. Epstein L. H., Wing R. R., Koeske R., Valoski A. Long-term effects of family-based treatment of childhood obesity. J Consult Clin Psychol. 1987 Feb;55(1):91–95. doi: 10.1037//0022-006x.55.1.91. [DOI] [PubMed] [Google Scholar]
  16. Epstein L. H., Wing R. R., Penner B. C., Kress M. J. Effect of diet and controlled exercise on weight loss in obese children. J Pediatr. 1985 Sep;107(3):358–361. doi: 10.1016/s0022-3476(85)80506-0. [DOI] [PubMed] [Google Scholar]
  17. Feldman W., Feldman E., Goodman J. T. Culture versus biology: children's attitudes toward thinness and fatness. Pediatrics. 1988 Feb;81(2):190–194. [PubMed] [Google Scholar]
  18. Foreyt J. P. Issues in the assessment and treatment of obesity. J Consult Clin Psychol. 1987 Oct;55(5):677–684. doi: 10.1037//0022-006x.55.5.677. [DOI] [PubMed] [Google Scholar]
  19. Ginsberg-Fellner F., Jagendorf L. A., Carmel H., Harris T. Overweight and obesity in preschool children in New York City. Am J Clin Nutr. 1981 Oct;34(10):2236–2241. doi: 10.1093/ajcn/34.10.2236. [DOI] [PubMed] [Google Scholar]
  20. Ginsberg-Fellner F., Knittle J. L. Weight reduction in young obese children. I. Effects on adipose tissue cellularity and metabolism. Pediatr Res. 1981 Oct;15(10):1381–1389. doi: 10.1203/00006450-198110000-00016. [DOI] [PubMed] [Google Scholar]
  21. Gortmaker S. L., Dietz W. H., Jr, Sobol A. M., Wehler C. A. Increasing pediatric obesity in the United States. Am J Dis Child. 1987 May;141(5):535–540. doi: 10.1001/archpedi.1987.04460050077035. [DOI] [PubMed] [Google Scholar]
  22. Johnston F. E. Health implications of childhood obesity. Ann Intern Med. 1985 Dec;103(6 ):1068–1072. doi: 10.7326/0003-4819-103-6-1068. [DOI] [PubMed] [Google Scholar]
  23. Klesges R. C., Klem M. L., Hanson C. L., Eck L. H., Ernst J., O'Laughlin D., Garrott A., Rife R. The effects of applicant's health status and qualifications on simulated hiring decisions. Int J Obes. 1990 Jun;14(6):527–535. [PubMed] [Google Scholar]
  24. Kneebone G. M. Childhood obesity--the diagnosis and management. Aust Fam Physician. 1990 Mar;19(3):367–370. [PubMed] [Google Scholar]
  25. Leung A. K., Robson W. L. Childhood obesity. Postgrad Med. 1990 Mar;87(4):123-30, 133. doi: 10.1080/00325481.1990.11704600. [DOI] [PubMed] [Google Scholar]
  26. Mallick M. J. Health hazards of obesity and weight control in children: a review of the literature. Am J Public Health. 1983 Jan;73(1):78–82. doi: 10.2105/ajph.73.1.78. [DOI] [PMC free article] [PubMed] [Google Scholar]
  27. Millar W. J., Stephens T. The prevalence of overweight and obesity in Britain, Canada, and United States. Am J Public Health. 1987 Jan;77(1):38–41. doi: 10.2105/ajph.77.1.38. [DOI] [PMC free article] [PubMed] [Google Scholar]
  28. Must A., Jacques P. F., Dallal G. E., Bajema C. J., Dietz W. H. Long-term morbidity and mortality of overweight adolescents. A follow-up of the Harvard Growth Study of 1922 to 1935. N Engl J Med. 1992 Nov 5;327(19):1350–1355. doi: 10.1056/NEJM199211053271904. [DOI] [PubMed] [Google Scholar]
  29. Nieto F. J., Szklo M., Comstock G. W. Childhood weight and growth rate as predictors of adult mortality. Am J Epidemiol. 1992 Jul 15;136(2):201–213. doi: 10.1093/oxfordjournals.aje.a116486. [DOI] [PubMed] [Google Scholar]
  30. Paige D. M. Obesity in childhood and adolescence. Special problems in diagnosis and treatment. Postgrad Med. 1986 Jan;79(1):233-8, 243-5. doi: 10.1080/00325481.1986.11699249. [DOI] [PubMed] [Google Scholar]
  31. Peckham C., Stark O., Moynihan C. Obesity in school children: is there a case for screening? Public Health. 1985 Jan;99(1):3–9. doi: 10.1016/s0033-3506(85)80120-7. [DOI] [PubMed] [Google Scholar]
  32. Reybrouck T., Vinckx J., Van den Berghe G., Vanderschueren-Lodeweyckx M. Exercise therapy and hypocaloric diet in the treatment of obese children and adolescents. Acta Paediatr Scand. 1990 Jan;79(1):84–89. doi: 10.1111/j.1651-2227.1990.tb11336.x. [DOI] [PubMed] [Google Scholar]
  33. Saltzer E. B., Golden M. P. Obesity in lower and middle socio-economic status mothers and their children. Res Nurs Health. 1985 Jun;8(2):147–153. doi: 10.1002/nur.4770080208. [DOI] [PubMed] [Google Scholar]
  34. Smoak C. G., Burke G. L., Webber L. S., Harsha D. W., Srinivasan S. R., Berenson G. S. Relation of obesity to clustering of cardiovascular disease risk factors in children and young adults. The Bogalusa Heart Study. Am J Epidemiol. 1987 Mar;125(3):364–372. doi: 10.1093/oxfordjournals.aje.a114543. [DOI] [PubMed] [Google Scholar]
  35. Somerville S. M., Rona R. J., Chinn S. Obesity and respiratory symptoms in primary school. Arch Dis Child. 1984 Oct;59(10):940–944. doi: 10.1136/adc.59.10.940. [DOI] [PMC free article] [PubMed] [Google Scholar]
  36. Storlien L. H., Bird J. E., Silva P. A. Assessment of obesity in early childhood. Aust Paediatr J. 1987 Apr;23(2):131–135. doi: 10.1111/j.1440-1754.1987.tb02193.x. [DOI] [PubMed] [Google Scholar]
  37. Stunkard A. J., Foch T. T., Hrubec Z. A twin study of human obesity. JAMA. 1986 Jul 4;256(1):51–54. [PubMed] [Google Scholar]
  38. Stunkard A. J., Harris J. R., Pedersen N. L., McClearn G. E. The body-mass index of twins who have been reared apart. N Engl J Med. 1990 May 24;322(21):1483–1487. doi: 10.1056/NEJM199005243222102. [DOI] [PubMed] [Google Scholar]
  39. Stunkard A. J., Sørensen T. I., Hanis C., Teasdale T. W., Chakraborty R., Schull W. J., Schulsinger F. An adoption study of human obesity. N Engl J Med. 1986 Jan 23;314(4):193–198. doi: 10.1056/NEJM198601233140401. [DOI] [PubMed] [Google Scholar]
  40. Stunkard A., d'Aquili E., Fox S., Filion R. D. Influence of social class on obesity and thinness in children. JAMA. 1972 Aug 7;221(6):579–584. [PubMed] [Google Scholar]
  41. Tracey V. V., De N. C., Harper J. R. Obesity and respiratory infection in infants and young children. Br Med J. 1971 Jan 2;1(5739):16–18. doi: 10.1136/bmj.1.5739.16. [DOI] [PMC free article] [PubMed] [Google Scholar]
  42. Varni J. W., Banis H. T. Behavior therapy techniques applied to eating, exercise, and diet modification in childhood obesity. J Dev Behav Pediatr. 1985 Dec;6(6):367–372. [PubMed] [Google Scholar]
  43. Wadden T. A., Stunkard A. J., Rich L., Rubin C. J., Sweidel G., McKinney S. Obesity in black adolescent girls: a controlled clinical trial of treatment by diet, behavior modification, and parental support. Pediatrics. 1990 Mar;85(3):345–352. [PubMed] [Google Scholar]
  44. Wadden T. A., Stunkard A. J. Social and psychological consequences of obesity. Ann Intern Med. 1985 Dec;103(6 ):1062–1067. doi: 10.7326/0003-4819-103-6-1062. [DOI] [PubMed] [Google Scholar]
  45. Ward D. S., Bar-Or O. Role of the physician and physical education teacher in the treatment of obesity at school. Pediatrician. 1986;13(1):44–51. [PubMed] [Google Scholar]
  46. Williams C. L. Nutrition intervention and health risk reduction in childhood: creating healthy adults. Pediatrician. 1983;12(2-3):97–101. [PubMed] [Google Scholar]
  47. Woolf S. H., Battista R. N., Anderson G. M., Logan A. G., Wang E. Assessing the clinical effectiveness of preventive maneuvers: analytic principles and systematic methods in reviewing evidence and developing clinical practice recommendations. A report by the Canadian Task Force on the Periodic Health Examination. J Clin Epidemiol. 1990;43(9):891–905. doi: 10.1016/0895-4356(90)90073-x. [DOI] [PubMed] [Google Scholar]

Articles from CMAJ: Canadian Medical Association Journal are provided here courtesy of Canadian Medical Association

RESOURCES