Diagnosis and Screening for Obesity-Related Conditions Among Children and Teens Receiving Medicaid — Maryland, 2005–2010

The prevalence of obesity among children and adolescents in the United States tripled during 1980-2008 and plateaued during 2008-2010. This rise in obesity was associated with a rise in chronic conditions previously observed mostly in adults, including hypertension, hypercholesterolemia, and type 2 diabetes. In 2007, the American Academy of Pediatrics published Expert Committee recommendations for universal screening for overweight and targeted laboratory screening for metabolic disorders among children and adolescents with a body mass index (BMI) at or above the 85th percentile based on age or presence of certain risk factors. To assess the prevalence of overweight and obesity among children and teens enrolled in Maryland Medicaid or the Maryland Children's Health Program (MCHP) and whether or not the children were being screened for obesity-related conditions according to the Expert Committee recommendations, investigators from the Maryland Department of Health and Mental Hygiene computed BMI percentiles for age and sex on a random sample of persons aged 2-19 years enrolled in Maryland Medicaid or MCHP whose height and weight were measured during a well-child visit. Encounter records were used to identify obesity-related conditions and screening laboratory tests received. This study found that 16.5% of participants were overweight (BMI in the 85th-94th percentiles) and 21.4% were obese (BMI at or above the 95th percentile). Obesity was highest among those aged 12-19 years (25.6%) and among Hispanics (28.1%). The diagnosis of obesity-related conditions increased significantly with increasing BMI, with 33.5% of obese participants diagnosed with asthma, 7.9% diagnosed with dyslipidemia, and 7.2% diagnosed with depression. Only 29.9% of overweight and 40.2% of obese participants received a lipid panel test. The results of this investigation were communicated to pediatric, public health, and managed-care leaders. Efforts to communicate the need to increase obesity screening and laboratory testing among this population should continue.