Diagnosing Obesity in Children

Overview

Obesity in children is defined as an excess accumulation of body fat. The most commonly used method to assess obesity in children is the body mass index (BMI), which is calculated by dividing the child's weight in kilograms by the square of their height in meters.

To diagnose obesity in children, healthcare providers may use a combination of examinations, screening tests, and procedures. These help confirm a diagnosis and determine the type, severity, or stage of obesity. Here are the key points to consider:

• Initial Assessment: Healthcare providers start by assessing the child's linear growth. Children with obesity due to nutritional factors may have consistent or accelerated growth. On the other hand, children with an underlying endocrine disorder may have decreased linear growth.
• BMI Calculation: Body Mass Index (BMI) is a rough calculation that compares a person's weight to their height. It provides an initial indication of whether a child is overweight or obese. The BMI for children and teens is compared to BMI charts for the child’s or teen’s age and sex to determine if they are considered underweight, at risk for overweight, or overweight or obese. According to the US Centers for Disease Control and Prevention, a child or teen is considered overweight if their BMI is at or above the 85^th percentile for their height and weight. This means their BMI is higher than 85% of other children their age and sex. They are considered obese if their BMI is at or above the 95^th percentile.
• Diagnostic Tests for Health Risks: Healthcare providers may order specific tests to assess obesity-related health risks in children. These tests may include:
  • Blood tests: These examine cholesterol and glucose levels to assess cardiovascular and metabolic health.
  • Liver function tests: These evaluate liver health as obesity can increase the risk of fatty liver disease.
  • Diabetes screening: Tests such as fasting blood glucose, hemoglobin A1c, or glucose tolerance test can help identify diabetes risk.
  • Thyroid tests: If there is suspicion of an underlying endocrine disorder like Cushing's syndrome, thyroid hormone testing may be indicated.
  • Heart tests: An electrocardiogram (ECG or EKG) can assess heart function in children with obesity.
• Involvement of Specialists: Various healthcare professionals may be involved in diagnosing obesity in children, including:
  • Pediatricians or family doctors who provide primary care.
  • Endocrinologists who specialize in hormonal disorders.
  • Dietitians or nutritionists who can provide guidance on healthy eating habits.
  • Psychologists or mental health professionals who address any psychological factors related to obesity.
• Determining Type or Severity Obesity: To identify factors or indicators related to the type or severity of obesity in children, additional examinations and assessments may be performed:
  • Developmental assessment: In severe cases before the age of 5 years, genetic causes should be considered if children present with developmental delay or dysmorphic features.
  • Psychosocial assessment: This involves evaluating a family's circumstances and lifestyle factors to understand how they contribute to obesity development and maintenance. It includes assessing psychological well-being, family dynamics, and lifestyle behaviors such as nutrition, exercise, and sleep.

Other tests or procedures may be recommended based on initial findings or individual factors. If you have concerns about your child's weight or suspect they may have obesity, it's best to consult with a healthcare provider for an accurate diagnosis and appropriate management plan.