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Tests and diagnosis
By Mayo Clinic staffAs 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
Blood tests
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 for up to eight hours before the test. Your child's doctor should tell you whether your child should fast before a blood test.
- 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 March 28, 2012.
- Flegal KM, et al. Characterizing extreme values of body mass index-for-age by using the 2000 Centers for Disease Control and Prevention growth charts. American Journal of Clinical Nutrition. 2009;90:1314.
- Ford ES, et al. Concentrations of low-density lipoprotein cholesterol and total cholesterol among children and adolescents in the United States. Circulation. 2009;119:1108.
- The fourth report on the diagnosis, evaluation and treatment of high blood pressure in children and adolescents. National Heart, Lung, and Blood Institute. http://www.nhlbi.nih.gov/guidelines/hypertension/hbp_ped.htm. Accessed March 28, 2012.
- 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.
- Shrewsbury VA, et al. The role of parents in pre-adolescent and adolescent overweight and obesity treatment: A systematic review of clinical recommendations. Obesity Reviews. 2011;12:759.
- Baur LA, et al. Assessment and management of obesity in childhood and adolescence. Nature Reviews Gastroenterology & Hepatology. 2011;8:635.
- Ibele AR, et al. Adolescent bariatric surgery. Surgical Clinics of North America. 2011;91:1339.
- Dunican KC, et al. Pharmacotherapeutic options for overweight adolescents. Annals of Pharmacotherapy. 2007;41:1445.
- Woo T. Pharmacotherapy and surgery treatment for the severely obese adolescent. Journal of Pediatric Health Care. 2009;23:206.
- Meridia (prescribing information). Abbott Park, Ill.: Abbott Laboratories; 2010. http://www.meridia.net/. Accessed March 28, 2012.
- Xenical (prescribing information). Nutley, NJ.: Genentech, Inc.; 2012. http://www.gene.com/gene/products/information/xenical/. Accessed March 28, 2012.
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