An Increasing Trend in Health-Care Professionals Notifying Children of Unhealthy Weight Status: NHANES 1999–2014

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International Journal of Obesity






Background: 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.

Methods: 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?'

Results: 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.

Conclusions: Notification of child’s unhealthy weight by HCPs increased significantly between 1999 and 2014, but the opportunity of clinical intervention remained substantially under-utilized.