The feasibility of screening for obesity-related co-morbidities in children attending community weight management services

Background
NICE public health guidance 47 recommended screening for obesity-associated co-morbidities in children attending community weight management services to identify those at risk, and provide support/treatment to minimise future complications.
Aim
Assess the feasibility of developing a screening programme for obesity-associated co-morbidities in children.
Methods
The programme of work consisted of three stages based on the National Screening Committee’s criteria:
1. A systematic review and meta-analyses of observational studies to determine the prevalence ratios of co-morbidities in children who were overweight and obese, relative to those of a healthy weight using a random effects model.
2. Results were presented to a panel of health professionals and researchers, and a separate panel of service users to obtain consensus on co-morbidities and screening methods for the proposed screening programme.
3. Feasibility of the proposed screening programme was assessed via thematic analysis of the transcripts from consensus meetings with the health professionals and researchers.
Results
1. Twenty-six co-morbidities from 162 studies including 1,801,388 children were identified. Prevalence ratios ranged from 1.4 (diabetes) to 58.0 (metabolic syndrome) for children with obesity, and 1.2 to 15.8, respectively, for children who are overweight, relative to those of a healthy weight.
2. Consensus was achieved for the screening of five co-morbidities, hyperglycaemia, hypertension, obstructive sleep apnoea, depression and anxiety. However, consensus for screening methods was not achieved.
3. Thematic analysis identified concerns regarding the appropriateness of screening for the co-morbidities, relating to acceptability of screening methods and impact of the screening programme.
Conclusions
Although screening for five co-morbidities was deemed important, further work is required to explore costs and benefits of a screening programme in line with National Screening Committee criteria with regards to screening methods, treatment and the practicalities of implementing a screening programme.