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Childhood obesity: should primary school children be routinely screened? A systematic review and discussion of the evidence
  1. Marie Westwood1,
  2. Debra Fayter1,
  3. Suzanne Hartley2,
  4. Amber Rithalia1,
  5. Gary Butler3,
  6. Paul Glasziou4,
  7. Martin Bland5,
  8. John Nixon1,
  9. Lisa Stirk1,
  10. Mary Rudolf6
  1. 1Centre for Reviews and Dissemination, University of York, York, UK
  2. 2Clinical Trials Research Unit, University of Leeds, Leeds, UK
  3. 3Institute of Health Sciences, University of Reading, Reading, UK
  4. 4Department for Primary Health Care, University of Oxford, Oxford, UK
  5. 5Department of Health Sciences, University of York, York, UK
  6. 6Department of Community Paediatrics, Leeds Primary Care Trust and University of Leeds, Leeds, UK
  1. Correspondence to:
    Dr Marie Westwood
    Centre for Reviews and Dissemination, University of York, York YO10 5DD, UK; mew3{at}


Background: Population monitoring has been introduced in UK primary schools in an effort to track the growing obesity epidemic. It has been argued that parents should be informed of their child’s results, but is there evidence that moving from monitoring to screening would be effective? We describe what is known about the effectiveness of monitoring and screening for overweight and obesity in primary school children and highlight areas where evidence is lacking and research should be prioritised.

Design: Systematic review with discussion of evidence gaps and future research.

Data sources: Published and unpublished studies (any language) from electronic databases (inception to July 2005), clinical experts, Primary Care Trusts and Strategic Health Authorities, and reference lists of retrieved studies.

Review methods: We included any study that evaluated measures of overweight and obesity as part of a population-level assessment and excluded studies whose primary outcome measure was prevalence.

Results: There were no trials assessing the effectiveness of monitoring or screening for overweight and obesity. Studies focussed on the diagnostic accuracy of measurements. Information on the attitudes of children, parents and health professionals to monitoring was extremely sparse.

Conclusions: Our review found a lack of data on the potential impact of population monitoring or screening for obesity and more research is indicated. Identification of effective weight reduction strategies for children and clarification of the role of preventative measures are priorities. It is difficult to see how screening to identify individual children can be justified without effective interventions.

  • BMI, body mass index
  • IOTF, International Obesity Taskforce
  • NSC, National Screening Committee
  • PCT, Primary Care Trust
  • obesity
  • overweight
  • monitoring
  • screening
  • BMI

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  • MEW takes responsibility for the work from inception to publication and managed the project. GB, with MEW, conceived and formulated the project grant application. DF led all aspects of the systematic review from protocol development to the writing of the final report, and SH and AR performed all aspects of the systematic review. LS devised and conducted the searches. GB reviewed the protocol and final report and provided expert advice on issues connected with children’s growth and growth-related conditions. MR reviewed the protocol and final report and provided expert advice on issues connected with childhood obesity. PG provided advice on issues connected with screening and reviewed the protocol and final report, and MB and JN reviewed the protocols and final report and provided general advice.

  • This project was funded by the NIHR Health Technology Assessment Programme (project number 04/09/02) and will be published in full in Health Technology Assessment. See the HTA Programme website for further project information (

  • Competing interests: None.

  • Ethics approval: Not required.

    The views and opinions expressed herein are those of the authors and do not necessarily reflect those of the Department of Health.

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