Different kinds of data were collected to aid in analysis, and to get a better insight into the diagnosis of complications, which are as a result of overweight and obesity. Health-care providers collected data on anthropometric measurements of height and weight, used to calculate BMI, during well-child visits (Hurt, De Pinto, Watson, Grant & Gielner, 2014). Socio-demographic data were collected in terms of age, date of service, sex, date of birth, race/ethnicity.
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BMI was then determined and used to categorize subjects into groups: normal, underweight, overweight, and obese. Encounter data from Medicaid/MCHP was used to obtain information on patterns of comorbidities within the last five years for children/teens, and from birth for children under the age of five years. In addition, services such as medical history and laboratory tests were also abstracted.
The 9th edition of International Classification of Diseases, Clinical Modification (ICD-9-CM) was used to decipher the primary and secondary comorbidities linked to overweight and obesity. The ICD-9-CM was also used to point out screening, counseling, and family history connected to overweight and obesity.
Health-care providers used the Current Procedural Terminology codes to link laboratory tests to overweight and obesity. Morbidity patterns were presented in the percentages where the proportion of each condition, in relation to all conditions, was determined.
The results indicated that a large percentage of children and teens were overweight (BMI between 85th and 94th percentiles) and obese (BMI> 95th percentile): 16.5% and 21.4% respectively. The present results indicated that there was an increase in the rates of obesity in comparison to previous years, but statistically, there was no significant change from 2005 to 2010.
The prevalence of obesity was higher among the Hispanics compared to any other ethnic group; there no significant difference in the prevalence of obesity in relation to sex. In contrast to recommendations made by the Expert Committee for children whose BMI was beyond the normal scale, rates of laboratory screening tests such as lipid panel testing and fasting glucose test were fewer (Barlow, 2007).
The lipid panel testing is recommended for children with a BMI for age and sex ≥ to 85th percentile, are ≥ ten years and with risk factors for comorbidities. The Fasting glucose test was recommended for children with a BMI ≥ 95th percentile. Medical conditions associated with BMI, as well as visits to the emergency department increased as BMI increased.
Asthma, dyslipidemia, and depression were frequent comorbid conditions. Family history assessment on comorbidities was recommended, but few children and teens went through the process. In addition, there was poor reception of dietary/exercise counseling.
The results of the investigation were used to show that obesity was still of great health concern; hence, increased need for screening and laboratory testing for comorbidities associated with overweight and obesity among children/teens. This investigation is very imperative for policymakers because policies to aid in early detection of comorbidities associated with overweight and obesity among the children/teens should be formulated, such as increased access to screening and testing by making the services more affordable.
Program planners should aid in the implementation of these policies; they should ensure that screening and testing tools are readily available at multiple locations to enable more children and teens to be screened and tested. In addition, they should use the information from this investigation to determine the distribution of resources, and develop programs that will increase awareness and promote healthy living.
Barlow S. E. (2007). Expert committee recommendations regarding the prevention, assessment, and treatment of child and adolescent overweight and obesity: summary report. Pediatrics, 120(Suppl 4), S164–92.
Hurt, L., De Pinto, C., Watson, J., Grant, M., & Gielner, J. (2014). Diagnosis and Screening for Obesity-Related Conditions among Children and Teens Receiving Medicaid-Maryland, 2005-2010. Morbidity and Mortality Weekly Report, 63(14), 305-308.