Monitor patient’s weight and provide appropriate guidance regarding nutrition and physical activity to prevent adult diseases
Brian Kit MD
What to Do – Gather Appropriate Data
Scope of the Problem
According to the Centers for Disease Control and Prevention (CDC), the prevalence of obese children in the United Sates tripled to 16% from 1980 to 2002. Despite this, pediatricians often both overlook and fail to disclose the diagnosis in affected children and teens. The increased prevalence of obesity has resulted in an increase in associated medical problems, including diabetes, hypertension, and dyslipidemia. These conditions are beginning to present during childhood. The focus on childhood obesity is based on evidence that obese children become obese adults and will be at risk for significant and lifelong comorbidity.
Definitions
To thwart the rise in childhood obesity and to avoid its associated complications, pediatricians and other providers must have an understanding of the definition of obesity and related terms. The key definitions are listed below.
Body Mass Index (BMI): BMI, defined as weight in kilograms divided by height in meters squared (kg/m2), is an indirect measurement of adiposity. Although there are limitations of its ability to measure adiposity, it is the most acceptable screen for obesity in children ages 2 to 18 years.
Underweight: BMI <10th percentile for age.
Normal Weight: BMI between the 10th and 85th percentile for age.
Overweight: BMI >85th percentile for age.
Obese: BMI >95th percentile for age.
Health Supervision for Overweight and Obese Children
All patients should have a BMI calculated at least annually during a well-child visit and charted on the CDC’s National Center for Health Statistics charts for BMI. The charts are available online at http://www.cdc.gov/growthcharts.
If the child is overweight or obese, the practitioner should take into consideration the following points:
If the child is overweight or obese, the practitioner should take into consideration the following points:
Discuss with the family the clinical definition of obesity and the importance of early identification. Focus the discussion on the health benefits of addressing obesity and the child’s positive qualities.
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