Childhood obesity is a growing problem in the United States. About 17% of children and adolescents in the U.S. are obese. There are many serious health consequences of being obese, including increased risk of developing type 2 diabetes, high blood pressure and high cholesterol, joint problems, sleep apnea, and social and psychological problems. Children who continue to be overweight into adulthood are at greater risk for serious health problems, including heart disease, stroke, and some cancers.
The American Academy of Pediatrics (AAP) recommends routine obesity screening of children starting at age 2. At least once a year, a healthcare practitioner should assess a child's weight status. This is the recommendation of a federally-convened expert committee, one that represents 15 national healthcare organizations, including AAP. The child's weight and height as well as age and sex are considered in determining the child's body mass index (BMI) percentile. BMI is a useful tool for estimating body fat.
- Overweight: An overweight child (one whose BMI is between the 85th percentile and the 94th percentile on standardized growth charts) faces additional health risks.
- Obese: An obese child (at or above the 95th percentile on standardized growth charts) faces even more serious health risks.
For children aged 2 years and older, AAP says BMI changes should be monitored by calculating and plotting BMI on the Centers for Disease Control and Prevention (CDC) growth charts at every healthcare visit so that interventions can be implemented when a child starts to cross BMI percentiles upward, even before he or she approaches the 85th or the 95th percentile.
The U.S. Preventive Services Task Force (USPSTF) recommends that clinicians screen children ages 6 and older for obesity and refer them to programs 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. The American Academy of Family Physicians makes the same recommendation.
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 healthcare provider can take. The goal is to prevent and address the problems of overweight and obesity through identification and early interventions, namely, changes to diet and exercise, to achieve a healthy weight and BMI.
Children's body mass calculations need to be accurate and related to their growth charts. A visit to a healthcare practitioner will provide you with the most reliable information, but the calculator on the CDC web site (in Links below) can help you determine if your child is at risk of being overweight.
Sources Used in Current Review
Centers for Disease Control and Prevention. Childhood Obesity Facts. Available online at https://www.cdc.gov/obesity/data/childhood.html. Accessed October 2016.
U.S. Preventive Services Task Force. Obesity in Children and Adolescents: Screening. Available online at https://www.uspreventiveservicestaskforce.org/Page/Document/UpdateSummaryDraft/obesity-in-children-and-adolescents-screening1?ds=1&s=child%20obesity%20screening. Accessed October 2016.
American Academy of Pediatrics. Press Room: AAP Updates Recommendations on Obesity Prevention. Available online through https://www.aap.org. Accessed October 2016.
Daniels, Stephen R. and Hassink, Sandra G. and the Committee on Nutrition. The Role of the Pediatrician in Primary Prevention of Obesity. Pediatrics. July 2015, Vol 136 / Issue 1. Available online at http://pediatrics.aappublications.org/content/136/1/e275. Accessed October 2016.
Herman, Amy Orciari. USPSTF Again Recommends Obesity Screening in Kids, Clarifies Age Group. NEJM Journal Watch. November 2, 2016. Available online at http://www.jwatch.org/fw112212/2016/11/02/uspstf-again-recommends-obesity-screening-kids-clarifies?query=pfwTOC&jwd=000020042086&jspc=. Accessed October 2016.