As part of regular well-child care, the doctor calculates your child's body mass index (BMI) and determines where it falls on the national BMI-for-age growth chart. The BMI helps indicate if your child is overweight for his or her age and height.
Using the growth chart, your doctor determines your child's percentile, meaning how your child compares with other children of the same sex and age. So, for example, you might be told that your child is in the 80th percentile. This means that compared with other children of the same sex and age, 80 percent have a lower BMI.
Cutoff points on these growth charts, established by the Centers for Disease Control and Prevention (CDC), help identify overweight and obese children:
- BMI-for-age between 85th and 94th percentiles — overweight
- BMI-for-age 95th percentile or above — obesity
Because BMI doesn't consider things like being muscular or having a larger than average body frame and because growth patterns vary greatly among children, your doctor also factors your child's growth and development into consideration. This helps determine whether your child's weight is a health concern.
In addition to BMI and charting weight on the growth charts, the doctor also evaluates:
- Your family's history of obesity and weight-related health problems, such as diabetes
- Your child's eating habits
- Your child's activity level
- Other health conditions your child may have
Your child's doctor may order blood tests if he or she finds that your child is obese. These tests include:
- A cholesterol test
- A blood sugar test (fasting blood glucose)
- Other blood tests to check for hormone imbalances that could affect your child's weight
Some of these tests require that your child not eat or drink anything before the test. Your child's doctor should tell you whether your child needs to fast before a blood test and for how long.
Feb. 15, 2014
- About BMI for children and teens. Centers for Disease Control and Prevention. http://www.cdc.gov/healthyweight/assessing/bmi/childrens_BMI/about_childrens_BMI.html. Accessed Sept 25, 2013.
- Understanding childhood obesity. American Heart Association. http://www.heart.org/HEARTORG/GettingHealthy/WeightManagement/Obesity/Childhood-Obesity_UCM_304347_Article.jsp. Accessed Sept. 25, 2013.
- Hay WW, et al. Current Diagnosis & Treatment: Pediatrics. 21st ed. New York, N.Y.: The McGraw-Hill Companies; 2012. http://www.accessmedicine.com/resourceTOC.aspx?resourceID=14. Accessed Sept. 18, 2013.
- Huang JS, et al. Childhood obesity for pediatric gastroenterologists. Journal of Pediatric Gastroenterology and Nutrition. 2013;56:99.
- Klish WJ. Definition; epidemiology; and etiology of obesity in children and adolescents. http://www.uptodate.com/home. Accessed Sept. 18, 2013.
- Barlow SE, et al. Expert committee recommendations regarding the prevention, assessment and treatment of child and adolescent overweight and obesity: Summary report. Pediatrics. 2007;120:S164.
- Currie C, et al. Is obesity at individual and national level associated with lower age at menarche? Evidence from 34 countries in the health behaviour in school-aged children study. Journal of Adolescent Health. 2012;50:621.
- Keeping children at a healthy weight: A review of the research on ways to avoid becoming overweight or obese. Agency for Healthcare Research and Quality. http://effectivehealthcare.ahrq.gov/search-for-guides-reviews-and-reports/?pageaction=displayproduct&productID=1714. Accessed Sept. 18, 2013.
- Skelton JA. Management of childhood obesity in the primary care setting. http://www.uptodate.com/home. Accessed Sept. 18, 2013.
- Petjar R, et al. Pharmacological management of obese child. Archives of Diseases in Childhood Education and Practice Edition. 2013;98:108.
- Sherafat-Kazemzadeh R, et al. Pharmacotherapy for childhood obesity: present and future prospects. International Journal of Obesity. 2013;37:1.
- O'Gorman CSM, et al. Considering statins for cholesterol-reduction in children if lifestyle and diet changes do not improve their health: a review of the risks and benefits. Vascular Health and Risk Management. 2011:7;1.