Screening Tests for Children (Ages 2 to 12)

About 17 percent of children and adolescents in the United States are overweight. This serious health problem extends from preschoolers to teens; both groups in this country are increasingly overweight. Excess weight interferes with proper growth of leg and hip bones, creating both immediate and lifelong problems. Troubling problems associated with being overweight and obesity also include diabetes, sleep apnea, social and psychological problems, high cholesterol, and elevated blood pressure. Children who continue to be overweight into adulthood are at greater risk for serious health problems, including heart disease, stroke, and some cancers.

At least once a year, a health care provider should assess the child’s weight. This is the recommendation of a federally convened “expert committee,” one that represents 15 national health care organizations. The child’s height, weight, age, and gender are considered in determining the child’s body mass index (BMI) percentile.

• Overweight: An overweight child (one whose BMI is between the 85th percentile and the 94th percentile) faces additional health risks.
• Obese: An obese child (at or above the 95th percentile) faces even more serious health risks.

The US Preventive Services Task Force revised its guidelines in early 2010 to recommend that clinicians screen children ages 6 to 18 years for obesity and offer or refer them to intensive counseling and behavioral interventions to promote improvements in weight status. The task force has found that the BMI is an acceptable measure for determining excess weight and defines "overweight" and "obese" as above.

Being overweight is one of the most common problems seen by pediatricians. At each well-child visit, the following should be discussed: the child’s dietary patterns, levels of physical activity, and sedentary behaviors. The family’s history of obesity, type 2 diabetes, and high blood pressure are important considerations as are a number of other physical measurements the health care provider can take. The goal is to prevent and address the problems of overweight and obesity through education and early interventions.

The health care provider will discuss the health threats and the changes the child and family can make to avoid them. Cholesterol testing, for example, is appropriate to begin when the child is overweight. Type 2 diabetes is also a threat for overweight children.

Children’s body mass calculations need to be accurate and related to their growth charts. A visit to a health care provider will provide you with the most reliable information, but the calculator at the following web site helps you see if your child is at risk of being overweight. This CDC website uses slightly different terminology than used above.

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Sources

Barlow SE and the Expert Committee. Expert Committee recommendations regarding the prevention, assessment, and treatment of child and adolescent overweight and obesity: summary report. Dec 2007(suppl). Pediatrics 120:S164-S192. Available online at http://pediatrics/aappublications.org. Accessed 10 Jan 2008.

US Centers for Disease Control and Prevention. BMI calculator for child and teen. Reviewed 30 Jul 2007, updated 8 Jan 2008. Available online at http://apps.nccd.cdc.gov. Accessed 8 Jan 2008.

The Obesity Society. Childhood overweight. Available online at http://naaso.org. Accessed 7 Jan 2008.

US Centers for Disease Control and Prevention. Childhood overweight. Last reviewed 18 Apr 2007. Available online at http://www.cdc.gov. Accessed 8 Jan 2008.

Krebs NF et al. Assessment of child and adolescent overweight and obesity. Dec 2007. Pediatrics 120:S193-228. Available online at http://pediatrics.aappublications.org. Accessed 28 Jan 2008.

US Centers for Disease Control and Prevention. Overweight and obesity: frequently asked questions. Available online at http://www.cdc.gov. Accessed 8 Jan 2008.

American Academy of Pediatrics, Committee on Nutrition. Prevention of pediatric overweight and obesity (policy statement). 2 Aug 2003 (reaffirmed 1 Feb 2007). Pediatrics 112(2):424-430. Available online at http://aappolicy.aappublications.org. Accessed 23 Jul 2004 and 7 Jan 2008.

US Preventive Services Task Force. Screening for Obesity in Children and Adolescents: US Preventive Services Task Force Recommendation Statement. Pediatrics (doi:10.1542/peds.2009-2037). Available online at http://pediatrics.aappublications.org/cgi/content/abstract/peds.2009-2037v1 through http://pediatrics.aappublications.org. Accessed January 2010.