School-based obesity treatment: the MATCH program.

NCMJ vol. 74, no. 1 ncmedicaljournal.com percentile and below the 95th percentile is considered to be overweight; and one whose BMI is at or above the 95th percentile is considered to be obese. Because BMI is based on height and weight, which are regularly measured during primary care visits, obesity screening can occur at the same intervals as standard well-child care beginning at age 2 years. For children younger than 2 years, the ratio of weight to length can be used rather than the ratio of weight to height, and those whose ratio puts them at or above the 95th percentile for children of the same age and sex are considered to be overweight. Pediatric primary care providers who screen for and document overweight and obesity are more likely to counsel patients and their parents about diet and exercise [11] and to screen and refer for comorbidities of overweight [12]. Use of toolkits encouraging screening and communication is associated with change in parental perception of overweight and positive dietary and physical activity changes [13]. Parents with accurate perception of weight status are more likely to be ready to make weight-related behavioral changes [14]. Lack of communication with families about weight status of overweight children is the strongest predictor of parental misclassification of a child, and pediatricians need to remember that their opinions are highly valued by patients [15]. The majority of parents with overweight children do not recognize that their overweight child weighs too much [16], and even fewer have ever been told by a clinician that their School-Based Obesity Treatment: The MATCH Program