Pediatric Obesity—Assessment, Treatment, and Prevention
Publication Date: January 31, 2017
Last Updated: December 16, 2022
Diagnosis
Diagnosing Overweight and Obesity
ES recommends using body mass index (BMI) and the Centers for Disease Control and Prevention (CDC) normative BMI percentiles to diagnose overweight or obesity in children and adolescents ≥2 years of age. ( 1-M )
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ES recommends diagnosing a child or adolescent >2 years of age as overweight if the BMI is ≥85th percentile but <95th percentile for age and sex, as obese if the BMI is ≥95th percentile, and as extremely obese if the BMI is ≥120% of the 95th percentile or ≥35 kg/m2. ( 1-L )
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ES suggests that clinicians take into account that variations in BMI correlate differently to comorbidities according to race/ ethnicity and that increased muscle mass increases BMI. ( 2-VL )
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ES suggests calculating, plotting, and reviewing a child's or adolescent's BMI percentile at least annually during well-child and/or sick-child visits. ( UGPS )
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ES suggests that a child <2 years of age be diagnosed as obese if the sex-specific weight for recumbent length is ≥97.7th percentile on the World Health Organization (WHO) charts, since US and international pediatric groups accept this method as valid. ( 2-VL )
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ES recommends against routine laboratory evaluations for endocrine etiologies of pediatric obesity unless the patient's stature and/or height velocity are attenuated (assessed in relationship to genetic/familial potential and pubertal stage). ( 1-M )
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ES recommends that children or adolescents with a BMI of ≥85th percentile be evaluated for potential comorbidities (see Table 2 and Fig. 1). (1-M)
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ES recommends against measuring insulin concentrations when evaluating children or adolescents for obesity. ( 1-M )
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Prevention
ES suggests that clinicians promote and participate in the ongoing healthy dietary and activity education of children and adolescents, parents, and communities, and encourage schools to provide adequate education about healthy eating. ( 2-VL )
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Overview
Title
Pediatric Obesity—Assessment, Treatment, and Prevention
Authoring Organization
Endocrine Society