Introduction
- Obesity is a complex multifactoral chronic disease that develops from an interaction between genetics and the environment.
- The development of obesity involves the integration of family, behavioral, cultural, physiological, metabolic and genetic factors.
- Treatment of obesity should be based on a multicomponent weight management program.
- Unlike adults, who are defined as overweight or obese depending on the absolute value of their body mass index (BMI) (kg/m2), BMI percentiles are used for children and adolescents. BMI percentile indicates the position of a child’s BMI relative to children of the same sex and age (US Centers for Disease Control Growth Charts).
- Throughout this pocket guide the terms “overweight” will be used to classify children whose BMI is between the 85th and 94th percentile and “obese” and “obesity” will be used as a general designation for children whose BMI is greater than or equal to the 95th percentile.
Table 1. Terminology for BMI Categories
| BMI Category | Former Terminology | Recommended Terminology |
|---|---|---|
| <5th percentile | Underweight | Underweight |
| 5th to 84th percentile | Healthy weight | Healthy weight |
| 85th to 94th percentile | At risk of overweight | Overweight |
| ≥95th percentile | Overweight or obesity | Obesity |
Nutrition Assessment
PWM: Assessment of Fast Food Meal Frequency in Children and Teens
- The registered dietitian nutritionist (RDN) should assess the frequency of fast-food intake of overweight or obese children and teens. Limited evidence in populations eight years to 16 years of age at baseline suggests that higher frequency of fast-food consumption, particularly more than twice a week is associated with increased adiposity; BMI Z-score; or risk of obesity during childhood, adolescence and during the transition from adolescence into adulthood. (Weak, Imperative)