Purpose The purpose of this study was to determine the rate of assessment and treatment of adolescent patients greater than the 85th percentile BMI in a primary care adolescent clinic. This study will provide baseline data to develop a screening and intervention program for overweight/obese adolescents.
Methods All adolescents (11-18 yrs) who had primary care visits and were seen in a 3 mo period were eligible for inclusion in the study. Of the 367 reviewed charts only 261 had well-child visits and were included in the study.
Results 78.9% female, 40.6% had BMIs > 85th percentile, with 27.2% > 95th percentile. Only 30.3% had BMIs calculated and only 16.5% BMIs plotted with 41% of those in the > 95th percentile category. Of the teens between 85th and 95th BMI, only 29% received counseling (22% from MD and 78% from RD). Only 45% who were > 95th percentile BMI received counseling (28% from MD and 72% from RD). Since the majority were female we also looked at contraceptive use. There were no significant differences in BMI found between those using contraceptive (OCPs, patch or Depo) and those not using contraceptive. Forty-seven percent of those with > 95th percentile BMI had BP > 95th percentile for age and height. The frequency of symptoms were asthma, 19.5%; joint pain, 16.1%; acanthosis nigricans, 6.5%; PCOS, 2.3%; sleep apnea symptoms, 1.1%.
Conclusions Despite a high number of overweight/obese patients (40.6%) routine screening with BMI was limited and few were counseled for weight loss despite other comorbidities (BP > 95th percentile and physical symptoms). Improvements in BMI screening are needed as well as the development of a practical screening and intervention tool, which would greatly enhance care for this population.
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