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Overweight Children and Adolescents: Screen, Assess and Manage

Screening Children and Adolescents for Overweight
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3. Screening Children and Adolescents for Overweight

Screening Procedure Using BMI-for-age:

Graphic showing Recommended Overweight Screening Procedures: If BMI is overweight, undergo in-depth medical assessment; if BMI is At Risk of Overweight, and if Family History, Blood Pressure, Total Cholesterol, Large Change in BMI, or Concern about Weight are evident, conduct In-depth medical assessment (if none of these factors are evident, Note in Chart, Take no therapeutic action, and have patient return next year for screen); if BMI shows No Risk of Overweight, have patient return next year for screen.

 

Reproduced with permission from the American Journal of Clinical Nutritionists, 1994; 59; 307-316. © Am J Clin Nutr. American Society for Clinical Nutritionists.

Children and adolescents aged 2 to 20 years identified as overweight (a BMI-for-age at or above the 95th percentile) require an in-depth medical assessment and weight management. Further assessment will help verify excess body fat and determine if complications such as hyperlipidemia or hypertension are present that indicate a recommendation for weight loss.

Children and adolescents with a BMI-for-age between the 85th and 95th percentiles need further evaluation that might include a family history, the family's and/or the patient's concern about weight, blood pressure and total cholesterol screening, and determination of any recent, large changes in BMI-for-age. If no risk factors are identified, rescreen in one year.

Weight-for-age and stature-for-age are useful indices to help monitor growth and to interpret changes in BMI-for-age. However, they are incomplete screening indices by themselves and need to be used in combination with BMI-for-age. Weight-for-age reflects body mass relative to chronological age. Short-term changes, such as an increase in weight-for-age, may result in a change in the BMI-for-age. Likewise, changes in stature also affect BMI-for-age. The following examples demonstrate the advantages of using BMI-for-age in combination with weight-for-age and stature-for-age to screen for overweight.

 

Example 1
 

Example 2

 

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