Identifying infants at risk of becoming obese: Can we and should we?

Objectives: Increased understanding of the risk factors for childhood obesity has raised the possibility of identifying infants who are at risk of becoming overweight or obese, enabling early intervention for infants at high risk. This paper considers the known risk factors, describes statistical work aimed at identifying risk, and considers the ethical and practical issues of such a development. Study design and methods: An overview of the published evidence for risk factors in the early development of overweight and obesity, and a statistical assessment of the practicality of developing a simple obesity risk assessment tool (ORT) for use in the primary care setting. Results: Analysis of data from two currently available UK birth cohort studies suggests that an ORT based on these data does not provide acceptable levels of specificity and sensitivity for use in a primary care setting. Conclusion: Further development of an ORT using additional data and enhanced statistical analysis may lead to a practical tool. However the practical, ethical and legal issues involved in its use, and the public health policy considerations that follow must be resolved.