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Defining Childhood Obesity

BMI for Children and Teens

Body mass index (BMI) is a measure used to determine childhood overweight and obesity. Overweight is defined as a BMI at or above the 85th percentile and below the 95th percentile for children and teens of the same age and sex. Obesity is defined as a BMI at or above the 95th percentile for children and teens of the same age and sex.

BMI is calculated by dividing a person’s weight in kilograms by the square of height in meters. For children and teens, BMI is age- and sex-specific and is often referred to as BMI-for-age. A child’s weight status is determined using an age- and sex-specific percentile for BMI rather than the BMI categories used for adults. This is because children’s body composition varies as they age and varies between boys and girls. Therefore, BMI levels among children and teens need to be expressed relative to other children of the same age and sex.

For example, a 10-year-old boy of average height (56 inches) who weighs 102 pounds would have a BMI of 22.9 kg/m2. This would place the boy in the 95th percentile for BMI, and he would be considered as obese. This means that the child’s BMI is greater than the BMI of 95% of 10-year-old boys in the reference population.

The CDC Growth Charts are the most commonly used indicator to measure the size and growth patterns of children and teens in the United States. BMI-for-age weight status categories and the corresponding percentiles were based on expert committee recommendations and are shown in the following table.

Weight Status Category Percentile Range
Underweight Less than the 5th percentile
Normal or Healthy Weight 5th percentile to less than the 85th percentile
Overweight 85th to less than the 95th percentile
Obese 95th percentile or greater

BMI does not measure body fat directly, but research has shown that BMI is correlated with more direct measures of body fat, such as skinfold thickness measurements, bioelectrical impedance, densitometry (underwater weighing), dual energy x-ray absorptiometry (DXA) and other methods1,2,3. BMI can be considered an alternative to direct measures of body fat. A trained healthcare provider should perform appropriate health assessments in order to evaluate an individual’s health status and risks.

References

  1. Barlow SE and the Expert Committee. Expert committee recommendations regarding the prevention, assessment, and treatment of child and adolescent overweight and obesity: summary report. Pediatrics 2007;120 Supplement December 2007:S164—S192.
  2. Cote AT, Harris KC, Panagiotopoulos C, et al. Childhood obesity and cardiovascular dysfunction. J Am Coll Cardiol 2013; 62 (15):1309–1319.
  3. Whitlock EP, Williams SB, Gold R, Smith PR, Shipman SA. Screening and interventions for childhood overweight: a summary of evidence for the US Preventive Services Task Force. Pediatrics. 2010;116(1):e125—144.
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