Evaluation and Management of Obesity in Children and Adolescents

Mona A.H. Eissa, MD, PhD; Kathy B. Gunner, RN, MS, CPNP

Disclosures

J Pediatr Health Care. 2004;18(1) 

In This Article

Introduction and Methods of Measuring Obesity

Childhood obesity is a significant public health problem because of its immediate impact on the physical and psychological health of children and adolescents, and because it is a risk factor for the development of chronic diseases later in life. Surveys have shown a significant increase in the prevalence of obesity in childhood and adolescence in America. The cost of obesity and its associated illnesses is also increasing. For youth six to seventeen years of age, obesity-associated annual hospital costs increased more than three-fold, from $35 million during 1979 to 1981 to $127 million during 1997 to 1999 (Wang and Dietz, 2002).

Body mass index (BMI) is currently the standard method for obesity measurement in children and adolescents because it is easy, readily available, and correlates adequately with body fat and with obesity sequelae. Also, BMI is the standard method for obesity assessment in adults, and its use in children provides a uniform measure across age groups. BMI is interpreted using National Center for Health Statistics age and gender-specific percentile curves up to 20 years of age (Centers for Disease Control, 2000). BMI is defined as weight in kilograms divided by height in meters squared (kg/m2). Other methods of obesity measurement (skin fold thicknesses, body circumferences, dual energy x-ray absorptiometry, bioelectric impedance analysis, densitometry, computerized tomography, and magnetic resonance imaging) are used on a smaller scale and mostly for research purposes because of their high cost, low availability, and the requirement of a high level of training for users to ensure adequate reliability.

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