SCREENING
Annual measurement of weight and height without shoes and determination of body mass index (BMI)
and BMI percentile for gender and age is recommended for children and adolescents. Smoothed BMI
percentile curves based on nationally representative data are available from the Centers for Disease
Control and Prevention, National Center for Health Statistics for use with youth up to age 20.22
• BMI reflects muscle and skeletal mass as well as adipose tissue, but correlates with subcutaneous
and total body fatness in youth. Adolescents who are muscular (e.g., athletes) or who have a large
bone structure, frequently have a high BMI without having excess body fat.
• An expert panel on pediatric obesity has recommended that youth with a BMI above the 95th
percentile for gender and age be considered overweight. Those with a BMI above the 85th, but
below the 95th percentile are considered at risk for overweight.23
• Some researchers have defined overweight in youth as above the 85th BMI percentile.1
Many
adolescents at this BMI percentile will look significantly overweight, will demonstrate at least one
obesity-related risk factor, and may benefit from intervention.
• Excess body fatness can be differentiated from a high BMI related to lean tissue by measuring
triceps and subscapular skin fold thicknesses. BMI values above the 95th percentile for gender and
age are consistent with obesity.