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Overweight Children and Adolescents: Screen, Assess and Manage

Assessment of Overweight Children and Adolescents
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4. Assessment of Overweight Children and Adolescents

Example 1: Screening and assessment for early onset of overweight

Screening: The growth chart shows the BMI-for-age pattern of a boy who became overweight early in his preschool years. On the BMI-for-age chart at age 2, he was at the 50th percentile; his BMI-for-age increased rapidly, crossing the 75th and 85th percentiles to become at risk of overweight at 3 and 4 years old. His BMI-for-age continued to increase to above the 95th percentile at age 7, 11, and 13 years.
 
Age Weight Stature
BMI
2 28 1/4 lb 34 3/4"
16.4
3 38 1/4 lb 38 7/8"
17.8
4 43 1/2 lb 41 5/8" 17.6
7 69 1/4 lb 50 3/8" 19.2
11 111 lb 58 1/8" 23.1
13 166 1/4 lb 65 3/4"
27
  BMI-for-age chart with child's points plotted
  To understand how changes in weight and stature contributed to the increase in BMI-for-age, it is helpful to review the weight-for-age and stature-for-age curves. His stature-for-age at age 2 was above the 50th percentile and it increased to above the 90th percentile by age 13. However, his weight-for-age increased more rapidly than stature, i.e., from the 50th percentile at age 2 to greater than the 95th percentile at age 13, which contributed to the increase in BMI-for-age.
 
Age Weight Stature
BMI
2 28 1/4 lb 34 3/4"
16.4
3 38 1/4 lb 38 7/8"
17.8
4 43 1/2 lb 41 5/8" 17.6
7 69 1/4 lb 50 3/8" 19.2
11 111 lb 58 1/8" 23.1
13 166 1/4 lb 65 3/4"
27
  Stature-for-age and weight-for-age chart with child's points plotted
  Assessment: When this boy was identified as at risk of overweight on the BMI-for-age chart at age 3, he should have received a medical assessment, as well as additional nutrition and physical activity assessments. The information from the assessments could have been used to target efforts for appropriate weight management goals to prevent the development of overweight.
 

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