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Obesity in children

Last reviewed: 5 Oct 2024
Last updated: 25 Sep 2024

Summary

Definition

History and exam

Key diagnostic factors

  • body mass index (BMI) ≥95th percentile
  • weight ≥95th percentile for height
Full details

Other diagnostic factors

  • increased waist-hip ratio
  • hypertension
Full details

Risk factors

  • parents with obesity
  • rapid weight gain in infancy
  • weight gain in early childhood
  • non-Hispanic black or Hispanic ethnicity
  • poor socioeconomic status
  • sedentary lifestyle
  • intrauterine growth restriction
  • maternal gestational diabetes
  • diet high in energy-dense foods, fast foods, and high-sugar beverages
  • screen time >2-3 hours/day
  • sleep deprivation
  • exposure to corticosteroids, antibiotics, or acid-suppressing medication
  • urban environment
  • maternal smoking in pregnancy
  • maternal consumption of ultra-processed foods
Full details

Diagnostic tests

Tests to consider

  • fasting blood glucose
  • serum lipids
  • liver function tests
Full details

Emerging tests

  • DEXA
  • bioelectric impedance analysis
  • abdominal CT or MRI

Treatment algorithm

ONGOING

body mass index (BMI) ≥85th to 94th percentile (overweight)

body mass index (BMI) ≥95th percentile (obesity) or BMI ≥120% of 95th percentile (severe obesity)

Contributors

Authors

Dianne Deplewski, MD

Associate Professor of Pediatrics

Section of Adult and Pediatric Endocrinology

Program Director

Pediatric Endocrinology Fellowship Program

University of Chicago

Chicago

IL

Disclosures

DD declares that she has no competing interests.

Acknowledgements

We would like to acknowledge our Pediatric expert panel member, Dr Michael Cabana, for his contribution to this topic. MDC declares that he has served as a consultant and editor for McGraw Hill and Elsevier.

Peer reviewers

Eric M. Bomberg, MD, MAS

Assistant Professor of Pediatrics

Associate Director for Research Informatics, Center for Pediatric Obesity Medicine

Division of Endocrinology and Center for Pediatric Obesity Medicine

University of Minnesota Medical School

Minneapolis

MN

Disclosures

EMB declares that he has been a site principal investigator and site co-investigator for Novo Nordisk. EMB's research program is supported by the National Institutes of Health (NIH) National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK).

Steven S. Rothenberg, MD

Chief of Pediatric Surgery

The Mother and Child Hospital

Associate Clinical Professor of Surgery

University of Colorado

Denver

CO

Disclosures

SSR declares that he has no competing interests.

Seema Kumar, MD

Assistant Professor of Pediatrics

Mayo Clinic

Rochester

MN

Disclosures

SK declares that she has no competing interests.

Peter Bundred, MBBS, MD

Honorary Research Fellow

Department of Health Services Research

Institute of Psychology, Health and Society

University of Liverpool

Liverpool

UK

Disclosures

PB declares that he has no competing interests.

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