Adoption of Body Mass Index Guidelines for Screening and Counseling in Pediatric Practice

Many pediatricians ignore the American Association of Pediatricians (AAP) guidelines for using body-mass index (BMI) percentiles in obesity management. However, pediatricians share the belief that BMI percentiles can help prevent the disease. When pediatricians use only visual observation to screen for obesity, they often misdiagnose weight status. Public health officials have repeatedly endorsed the use of BMI percentiles to monitor obesity in children.

The study used an existing survey to assess whether pediatricians were implementing BMI guidelines to manage (i.e., screen for and treat) obesity. The authors mailed as many as seven rounds of self-administered surveys to 1,622 active AAP members. The surveys covered the following: (1) attitudes and practices during well-child visits; (2) barriers to screening and intervention: (3) treatment and referral practices; and (4) community resources.

This study reports the underlying beliefs that pediatricians held about their own abilities to manage child obesity. Factor analysis helped determine what underlying feelings dictated specific responses to survey questions.

Key Findings:

  • Pediatricians who had attended continuing medical education (CME) sessions were more likely to be familiar with AAP guidelines.
  • Pediatricians familiar with AAP guidelines were more likely to use BMI percentiles.
  • Pediatricians using BMI percentiles expressed more confidence in their ability to diagnose and treat obesity.

Training pediatricians to use BMI percentiles could decrease the occurrence of childhood obesity. This study asked pediatricians to self-report their attitudes and practices related to the screening and treatment of obesity. Factor analysis uncovered how pediatricians appraise their own abilities to manage the disease.