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3. Screening Children and Adolescents for Overweight

The information presented in the rest of the module consists of recommendations that represent the consensus of a group of experts who manage overweight children and adolescents (Barlow and Dietz, 1998). The recommendations are not evidence-based since few studies on evaluation and management of overweight children have been published.

BMI-for-age is recommended to screen children aged 2 to 20 years for at risk of overweight and overweight, in order to identify children who may need further assessment and possible treatment. Plot weight on the weight-for-age chart and stature on the stature-for-age chart to observe the influence of weight and stature on BMI-for-age for an individual child.

Children should be accurately weighed and measured to monitor growth according to the periodicity schedule of the American Academy of Pediatrics (AAP): Recommendations for Preventive Pediatric Health Care.*

Considerations when screening for overweight:

Infants and children under the age of two years

For infants and children under the age of two years, plot the weight-for-length, weight-for-age, and length-for-age CDC Growth Charts. Overweight, defined as a weight-for-length greater than the 95th percentile, does not pose the same risk among infants as it does among children 2 years and older. Overweight infants may not be at increased risk of being overweight in adulthood, and they do not have the medical risks associated with overweight in childhood (Whitaker et al., 1997).

Children 24 to 36 months of age

CDC recommends measuring stature for children 2 years and older who are able to stand on their own, calculating BMI and plotting it on the BMI-for-age chart. However, clinicians may choose to measure recumbent length and use the weight-for-length charts for children 2 to 3 years of age. Alternatively, the weight-for-stature charts can be used to plot stature from 77 to 121 centimeters. Whether the child's length or stature is measured determines which growth chart will be used. It is inappropriate to use a length measurement to calculate BMI-for-age. It is also inappropriate to use a stature measurement with either the length-for-age chart or the weight-for-length chart.

Adolescents

Adolescence represents the period of greatest risk for developing adult obesity (Whitaker, 1997). Measures of weight relative to stature, like BMI-for-age, are influenced by pubertal status. For early or late maturing children, these indices should be interpreted with caution (Himes and Dietz, 1994; Daniels et al., 1997). To learn more about stage of maturation and how it relates to BMI, see the module on Adolescent Physical Development: Uses and Limitations of the Growth Charts.*

*Links to non-Federal organizations are provided solely as a service to our users. Links do not constitute an endorsement of any organization by CDC or the Federal Government, and none should be inferred. The CDC is not responsible for the content of the individual organization Web pages found at this link.