Childhood Obesity
In April 2019, the Centers for Disease Control and Prevention (CDC) stated that childhood obesity in the U.S. has tripled since the 1970s. The prevalence of obesity was 19.3% and affected about 14.4 million children and adolescents. These children tend to grow up to be obese adults.1 People with obesity have a higher risk for heart disease, type II diabetes, fatty liver disease, joint disease, and breathing problems. Recently the CDC has linked obesity directly to 13 types of cancer. With the increase in childhood obesity, we are now seeing more children diagnosed with hypertension, heart disease, sleep apnea, cancer, and type II diabetes.
The CDC has recently raised the alarming idea that if things do not change we may see the
first generation of children that DO NOT outlive their parents.
The CDC indicates six factors that affect childhood obesity:
- Genetics,
- Metabolism,
- Eating and physical activity behaviors,
- Community design and safety,
- Short sleep duration, and
- Negative childhood events.2
Childhood obesity can be prevented, and you can help. During a child’s annual Texas Health Steps (THSteps) exam or well checkup, there are several safety nets in place to assist Providers in identifying and treating children that are tipping the scales at these higher weights, or who are at risk of doing so.
- Height, weight, body mass index (BMI), and BMI percentile are mandatory screening components for Texas Health Steps (THSteps) Children’s Health Insurance Program (CHIP), and the Healthcare Effectiveness Data & Information Set® (HEDIS®).3456
- A nutritional assessment is a requirement of all THSteps, CHIP, and HEDIS annual exams.456
- Preventive guidance at annual exams should ALWAYS include healthy diet and nutrition guidelines, recommendations for daily physical activity of 1 hour or more, and limited screen time. This is a requirement for THSteps and HEDIS.34
- Best Practice suggests Healthcare Providers offer ongoing, positive reinforcement for healthy behaviors and follow-up at every well-child visit.7
- Best Practice encourages an empathetic and empowering counseling style, such as motivational interviewing, be employed to support patient and family behavior change.7
- Laboratory testing for dyslipidemia should be performed for children between the ages of nine and 11 years. Laboratory testing for dyslipidemia should be done every two years for any child aged 24 months to 20 years with positive risk-based screening results.4
- Refer members to the MAGELLAN Healthcare Behavioral Services Hotline at 1-800-327-7390/TTY: 1-800-735-2988.
If you do your part at all annual exams, we have a chance to correct the CDC’s declaration and
help our children to live happy, HEALTHY, and long lives.
Resources:
Reference and review the BCBSTX Preventive Care Guidelines (PCGs), Clinical Practice Guidelines (CPGs) and THSteps for Medical Providers 
for more information on this and other important topics for treating your patients.
Reference the Behavioral Health Toolkit for Medical Providers at Magellan Behavioral Health Toolkit to ensure appropriate behavioral health for your patients.
References:
1 Centers for Disease Control and Prevention (CDC) (2019). Childhood obesity facts . Retrieved Aug. 30, 2019
2 Centers for Disease Control and Prevention (CDC) (2016). Childhood obesity causes & consequences . Retrieved Aug. 30, 2019
3 National Committee for Quality Improvement (NCQA). Measuring Quality. Improving Health Care. (2019) . Retrieved Sep. 5, 2019
4 Texas Health and Human Services. (2018). Texas Health Steps medical checkup periodicity schedule for infants, children and adolescents 
. Retrieved Sep. 17, 2019
5 National Center for Health Statistics (NCHS) at Centers for Disease Control and Prevention (CDC). (2019). Clinical growth charts . Retrieved September 6, 2019.
6 American Academy of Pediatrics (AAP). (2019). Recommendations for Preventative Pediatric Health Care . Retrieved Sept. 17, 2019.
7 American Academy Pediatrics (AAP) Institute for Healthy Childhood Weight (2015). Algorithm for the Assessment and Management of Childhood Obesity in Patients 2 Years and Older . Retrieved Sept. 11, 2019.
The above material is for informational purposes only and is not a substitute for the independent medical judgment of a physician or other health care provider. Physicians and other health care providers are encouraged to use their own medical judgment based upon all available information and the condition of the patient in determining the appropriate course of treatment. The fact that a service or treatment is described in this material is not a guarantee that the service or treatment is a covered benefit and members should refer to their certificate of coverage for more details, including benefits, limitations and exclusions. Regardless of benefits, the final decision about any service or treatment is between the member and their health care provider.
HEDIS is a registered trademark of NCQA. Use of this resource is subject to NCQA’s copyright, found here . The NCQA HEDIS measure specification has been adjusted pursuant to NCQA’s Rules for Allowable Adjustments of HEDIS. The adjusted measure specification may be used only for quality improvement purposes.
