Assessment

The question of how to manage childhood obesity is one that perplexes health professionals, and many are cautious about whether to intervene. As with adult obesity, making a thorough assessment will help to establish the most suitable course of action for an individual child and their family.

In making an assessment:

  • Take measurements of height and weight and plot this on the appropriate BMI centile chart
  • Record measurements of waist circumference and refer to the appropriate centile chart*
  • Note the child's and the family's weight history
  • Consider whether there may be any underlying medical causes
  • Assess patterns of eating and physical activity
  • Collect information about the child's physical and psychological health
  • Determine the expectations from treatment of both the child and their parent/guardian

The SIGN guidelines recommend referring the following groups to paediatric consultants:

  • All children under the age of 24 months with BMI >99.6th centile
  • Children over 24 months with BMI >99.6th centile who are at higher risk of obesity-related morbidity
  • Children who have already developed a serious obesity-related morbidity e.g. hypertension, sleep apnoea, orthopaedic problems, hypoventilation syndrome and psychological morbidity
  • Children with a suspected underlying medical casue of obesity

Factors, which may alert a health professional to an underlying medical cause of obesity include:

  • Developmental delays
  • Poor growth in height
  • Dysmorphic features
  • Hypogonadism